Assessment of extent of skin involvement in scleroderma using shear wave elastography

Introduction: Scleroderma (systemic sclerosis [SSc]) is a rare autoimmune disease which manifests as fibrosis in the skin and other internal organs. Conventionally, the modified Rodnan skin score (MRSS) has been used to quantify the extent of skin fibrosis (resulting in skin tightness) in SSc. This...

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Main Authors: Anupam Wakhlu, Abhra Chandra Chowdhury, Namita Mohindra, Saumya Ranjan Tripathy, Durga Prasanna Misra, Vikas Agarwal
Format: Article
Language:English
Published: SAGE Publishing 2017-01-01
Series:Indian Journal of Rheumatology
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Online Access:http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2017;volume=12;issue=4;spage=194;epage=198;aulast=Wakhlu
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author Anupam Wakhlu
Abhra Chandra Chowdhury
Namita Mohindra
Saumya Ranjan Tripathy
Durga Prasanna Misra
Vikas Agarwal
author_facet Anupam Wakhlu
Abhra Chandra Chowdhury
Namita Mohindra
Saumya Ranjan Tripathy
Durga Prasanna Misra
Vikas Agarwal
author_sort Anupam Wakhlu
collection DOAJ
description Introduction: Scleroderma (systemic sclerosis [SSc]) is a rare autoimmune disease which manifests as fibrosis in the skin and other internal organs. Conventionally, the modified Rodnan skin score (MRSS) has been used to quantify the extent of skin fibrosis (resulting in skin tightness) in SSc. This technique, although widely validated, is limited by the requirement of a trained, experienced assessor. Recent literature suggests that utilization of the objective ultrasound-based assessment of skin fibrosis utilizing shear wave elastography (SWE) may be a more robust technique to detect early skin tightness in SSc. Methods: We evaluated the use of SWE (assessed by an experienced radiologist) in 24 patients with SSc compared with 16 healthy controls. Results: Our patients were predominantly females, with median disease duration of 1.5 years and median MRSS of 17. There was minimal intraobserver variation in the assessment of SWE. Patients with SSc had higher SWE values (mean elasticity [Emean]) compared to healthy controls at most assessed sites for the MRSS. The Emeancorrelated significantly at all sites with the MRSS scores. At the sites where MRSS was scored as 0 (normal), the Emeanin patients with SSc was higher when compared with similarly clinical normal skin in patients with SSc, suggesting potential early involvement of these areas of the skin with fibrosis. Conclusion: SWE is a promising tool to objectively assess skin fibrosis in SSc and may be useful in detecting early, subclinical skin involvement in this disease.
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spelling doaj-art-08a4531845694f2c8bc648a028df5bd32025-02-03T11:42:39ZengSAGE PublishingIndian Journal of Rheumatology0973-36980973-37012017-01-0112419419810.4103/injr.injr_41_17Assessment of extent of skin involvement in scleroderma using shear wave elastographyAnupam WakhluAbhra Chandra ChowdhuryNamita MohindraSaumya Ranjan TripathyDurga Prasanna MisraVikas AgarwalIntroduction: Scleroderma (systemic sclerosis [SSc]) is a rare autoimmune disease which manifests as fibrosis in the skin and other internal organs. Conventionally, the modified Rodnan skin score (MRSS) has been used to quantify the extent of skin fibrosis (resulting in skin tightness) in SSc. This technique, although widely validated, is limited by the requirement of a trained, experienced assessor. Recent literature suggests that utilization of the objective ultrasound-based assessment of skin fibrosis utilizing shear wave elastography (SWE) may be a more robust technique to detect early skin tightness in SSc. Methods: We evaluated the use of SWE (assessed by an experienced radiologist) in 24 patients with SSc compared with 16 healthy controls. Results: Our patients were predominantly females, with median disease duration of 1.5 years and median MRSS of 17. There was minimal intraobserver variation in the assessment of SWE. Patients with SSc had higher SWE values (mean elasticity [Emean]) compared to healthy controls at most assessed sites for the MRSS. The Emeancorrelated significantly at all sites with the MRSS scores. At the sites where MRSS was scored as 0 (normal), the Emeanin patients with SSc was higher when compared with similarly clinical normal skin in patients with SSc, suggesting potential early involvement of these areas of the skin with fibrosis. Conclusion: SWE is a promising tool to objectively assess skin fibrosis in SSc and may be useful in detecting early, subclinical skin involvement in this disease.http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2017;volume=12;issue=4;spage=194;epage=198;aulast=WakhluFibrosismodified Rodnan skin scoresclerodermashear wave elastographyskin
spellingShingle Anupam Wakhlu
Abhra Chandra Chowdhury
Namita Mohindra
Saumya Ranjan Tripathy
Durga Prasanna Misra
Vikas Agarwal
Assessment of extent of skin involvement in scleroderma using shear wave elastography
Indian Journal of Rheumatology
Fibrosis
modified Rodnan skin score
scleroderma
shear wave elastography
skin
title Assessment of extent of skin involvement in scleroderma using shear wave elastography
title_full Assessment of extent of skin involvement in scleroderma using shear wave elastography
title_fullStr Assessment of extent of skin involvement in scleroderma using shear wave elastography
title_full_unstemmed Assessment of extent of skin involvement in scleroderma using shear wave elastography
title_short Assessment of extent of skin involvement in scleroderma using shear wave elastography
title_sort assessment of extent of skin involvement in scleroderma using shear wave elastography
topic Fibrosis
modified Rodnan skin score
scleroderma
shear wave elastography
skin
url http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2017;volume=12;issue=4;spage=194;epage=198;aulast=Wakhlu
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AT namitamohindra assessmentofextentofskininvolvementinsclerodermausingshearwaveelastography
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