Fast Five Quiz: Presentation and Diagnosis of Systemic Sclerosis

Dirk M. Elston, MD


February 04, 2021

In up to 10% of patients with SSc, chest radiographs may show normal findings, even when patients have respiratory tract symptoms. Other findings may include fibrosis of the basal parts of the lungs, which is observed in approximately 30%-60% of patients. On occasion, pictures of diffuse ground-glass and honeycomb lung patterns are observed. In patients with honeycomb lung patterns, changes are irreversible and can be an important contributor to treatment response.

Doppler echocardiography is used to detect cardiac abnormalities in patients with SSc. Diseases on the left and right sides of the heart are common in patients with SSc. Diastolic dysfunction is the most common cardiac finding. Because cardiac involvement is a major problem in SSc, evaluation of ventricular function using echocardiographic strain imaging should also be considered, as it appears to be useful to detect subclinical cardiac involvement in patients with normal standard echocardiographic and tissue Doppler velocity findings.

In SSc, thickening of the alveolar walls and intestinal tissue, and honeycomb-appearing lungs, are revealed by high-resolution CT (HRCT) and scintigraphy. Recently released evidence-based consensus statements for SSc-associated interstitial lung disease (SSc-ILD) recommend screening all patients with SSc for SSc-ILD using HRCT.

Bone radiography reveals generalized osteopenia in patients with SSc, which typically affects the hands. Intra-articular calcifications are frequently seen.

Learn more about imaging studies for SSc.


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