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ObjectivesValidating musculoskeletal ultrasound features of the joints and tendons of the hands in a large scleroderma cohort.MethodsA total of 81 scleroderma patients participated in this prospective, cross-sectional study. Grayscale and power Doppler musculoskeletal ultrasound images of 13 joints and 5 tendons of the wrist and hand were obtained. Clinical assessment included modified Rodnan skin thickness score, joint count, and Scleroderma Health Assessment Questionnaire. Face validity, content validity, construct validity, and feasibility were assessed.ResultsMean age was 53.8 years (range 22-80), 76.5% were females, and disease duration ranged from 0.25 to 29 years. Mean length of the examination was 36 min. Scleroderma Health Assessment Questionnaire-Disability Index correlated with musculoskeletal ultrasound erosions (r = 0.5, p = 0.0003). Skin score correlated with tendinitis grayscale (r = 0.26, p = 0.02). Intra-reader correlation coefficient for musculoskeletal ultrasound was 0.96 for the joints and could not be calculated for tendons because there were too few positive findings. When tendon changes existed, percent of agreement was 77.7%-83.3%.ConclusionMusculoskeletal ultrasound of 13 joints and 5 tendons of the hands and wrist has face and content validity. Construct validity was shown for the tendons and erosion scores. Feasibility and reliability were partially validated.

Background: Musculoskeletal ultrasound is increasingly used in the evaluation of joint inflammation. Power Doppler can identify increased hyperemia which indicates inflammation., Objectives: To measure the prevalence and level of positive Power Doppler signals at the hand joints of scleroderma patients., Methods: Ten scleroderma patients were examined by ultrasound of the dominant hand. Power Doppler signals were measured at the wrist as well as the metacarpophalangeal joints (MCPS), proximal interphalangeal joints (PIPS) and distal interphalangeal joints (DIPS) at the second to fifth fingers. Clinical information regarding age, gender, disease duration, level of involvement (limited or diffuse) and skin score were collected. The data were taken from a larger ultrasound study from UCLA University that examined the validation of ultrasound in scleroderma., Results: Mean age was 51.7 years and 70% were females; 212 joints were examined. Positive Power Doppler signals were found in 30% of patients and were mostly low grade. Power Doppler signals were found in 3.3% of the joints of scleroderma patients., Discussion: Level of Power Doppler signals which probably reflects the level of joint inflammation was low in the scleroderma patients and its prevalence was low.