mersin univ saglık bilim derg

Mersin Üniversitesi Sağlık Bilimleri Dergisi

1308-0830

Mersin University

10.26559/mersinsbd.460823

Health Care Administration

Sağlık Kurumları Yönetimi

Evaluation of the chronic pathologies in terminal phalanges of scleroderma patients by plain radiographs

Skleroderma olgularında ellerde oluşan kronik terminal falanks patolojilerinin direkt radyografi ile değerlendirilmesi

https://orcid.org/0000-0002-5414-2771

Döğen

Mehmet Ercüment

Mersin Şehir Eğitim ve Araştırma Hastanesi

https://orcid.org/0000-0002-7667-8008

Ayaz

Ümit Yaşar

Mersin Şehir Eğitim ve Araştırma Hastanesi

12 25 2018

11 3 336 341 09 17 2018 11 05 2018

2008

Mersin Üniversitesi Sağlık Bilimleri Dergisi

Purpose: We aimed to reveal terminal phalangealchanges in scleroderma patients by direct radiography.Materials and methods:Bilateral hand-wrists radiographs of eight womenwith a mean age of 36.4 years (range, 22-48 years) who were on follow-up withthe diagnosis of scleroderma were retrospectively evaluated for acral (terminalphalanx) pathologies and other hand-wrist changes.ResultsOn bilateral hand-wrist radiographs,flexion contractures with different degrees in 62.5% (n=5/8) of cases, claw hand and claw hand development processin 25% (n=2/8) of cases, arthritic and degenerative changes in variouslocalizations of the intercarpal ,carpometacarpal, metacarpophalangeal and interphalangeal joints in 75% (n=6/8) of cases, various degrees ofperiarticular osteoporosis were observed. In 25% (n=2/8) of cases, soft tissuecalcifications were detected distal to the fingers. Terminal phalanx resorption(acroosteolysis) and erosion were observed in 62.5% (n=2/8) cases. It has beendetermined that these periosteal resorption and erosions are more likely toaffect the palmar sides of the taft. Acroosteolysis was milder and more limitedin the two cases, and in the three cases, the terminal phalanges were seen asprominent cusps.Conclusion: Directradiography has been found to be useful in showing terminal phalangepathologies, especially acroosteolysis in chronic scleroderma cases, and thisshould be the first imaging method to be applied.

Amaç: Skleroderma olgularındaki terminal falanksdeğişikliklerini direkt radyografi ile ortaya koymayı amaçladık.Yöntem: Skleroderma tanısı ile izlenenve yaş ortalaması 36.4 yıl olan (aralık, 22-48 yıl), hepsi kadın sekiz olgununel-el bilek radyografileri akral (terminal falanks) patolojileri ve diğer el-elbileği değişiklikleri yönünden retrospektif olarak incelendi.Bulgular: Bilateral el-el bileğiradyografilerinde olgularının 5’inde (%62.5) değişik derecelerde fleksiyonkontraktürleri ve 2’sinde (%25.0) pençe el-pençe el gelişim süreci, 6’sında(%75.0) interkarpal, karpometakarpal, metakarpofalangeal ve interfalangeal eklemlerdedeğişik lokalizasyonlarda ve derecelerde artritik ve dejeneratif değişiklikler,değişik derecelerde periartiküler osteoporoz izlendi. Olguların 2’sinde (%25.0),parmakların distalinde yumuşak doku kalsifikasyonları saptandı. Olguların5’inde (%62,5) değişik derecelerde terminal falanks rezorpsiyonları(akroosteoliz), erozyon görüldü. Bu periosteal rezorpsiyon ve erozyonların,taftların palmar taraflarını daha çok etkilediği saptandı. Olguların2’sinde (%25.0) akroosteoliz daha hafif ve sınırlı olup, 3’ünde (%37.5)terminal falankslarda belirgin sivrileşmeler şeklinde görüldü.Sonuç: Direkt radyografi, kronikskleroderma olgularında başta akroosteoliz olmak üzere terminal falankspatolojilerini göstermede yararlı bulunmuş olup bu konuda başvurulacak ilkgörüntüleme yöntemi olmalıdır.

Skleroderma akroosteoliz radiografi elbilek

Scleroderma acro-osteolysis radiography wrist

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