Division of Rheumatology, Department of Physical, Medicine and Rehabilitation and Faculty of Medicine, Gevher Nesibe Hospital, Erciyes University, Kayseri, Turkey.
Am J Med Sci. 2014 May;347(5):382-6. doi: 10.1097/MAJ.0b013e31829a348b.
Systemic sclerosis (SSc), or scleroderma, is a severe connective tissue disease. Although musculoskeletal involvement is frequent and causes significant functional disability in patients with SSc, articular cartilage thickness has not been previously investigated. The aim of this study was to compare the femoral cartilage thickness (FCT) in patients with SSc with that of controls who were matched for age, body mass index and osteoarthritis prevalence.
The thickness of femoral articular cartilage was measured by ultrasonography in patients and controls. Three midpoint measurements were taken from each knee: lateral femoral condyle (LFC), femoral intercondylar area and medial femoral condyle (MFC).
Forty female patients with SSc and 85 female controls were included. In patients with SSc, 18 (45.0%) had diffuse SSc, 18 (45.0%) had limited SSc, 1 (2.5%) had overlap (polymyositis) and 3 (7.5%) had SSc sine scleroderma. The mean FCT measurements of patients with SSc at MFC of the right and left knees (1.86 and 1.84 mm, respectively) and LFC of the left knee (1.93 mm) were statistically lower than in the controls (right and left MFC, 2.23 and 2.25 mm, respectively, P < 0.0001, and left LFC 2.15 mm, P = 0.026).
Patients with SSc had thinner femoral cartilage compared with controls. The underlying possible mechanisms of thin FCT may be multifactorial, and there may be many influencing factors like immune activation, vasculopathy, oxidative stress and synovial fibrosis or markers of cartilage degradation. The possible factors influencing the change in cartilage thickness or metabolism in patients with SSc require further research.
系统性硬化症（SSc），又称硬皮病，是一种严重的结缔组织疾病。尽管肌肉骨骼受累在 SSc 患者中很常见，并导致其显著的功能障碍，但关节软骨厚度尚未得到研究。本研究旨在比较 SSc 患者与年龄、体重指数和骨关节炎患病率相匹配的对照组的股骨软骨厚度（FCT）。
使用超声检查测量患者和对照组的股骨关节软骨厚度。从每个膝关节的三个中点测量：外侧股骨髁（LFC）、股骨髁间区和内侧股骨髁（MFC）。
共纳入 40 名女性 SSc 患者和 85 名女性对照组。在 SSc 患者中，18 名（45.0%）患有弥漫性 SSc，18 名（45.0%）患有局限性 SSc，1 名（2.5%）患有重叠（多发性肌炎），3 名（7.5%）患有无硬皮病的 SSc。右侧和左侧 MFC 以及左侧 LFC 的 SSc 患者 FCT 平均值（右侧和左侧 MFC 分别为 1.86 和 1.84mm，左侧 LFC 为 1.93mm）均低于对照组（右侧和左侧 MFC 分别为 2.23 和 2.25mm，P<0.0001，左侧 LFC 为 2.15mm，P=0.026）。
与对照组相比，SSc 患者的股骨软骨较薄。FCT 变薄的潜在可能机制是多因素的，可能有许多影响因素，如免疫激活、血管病变、氧化应激和滑膜纤维化或软骨降解的标志物。需要进一步研究影响 SSc 患者软骨厚度或代谢变化的可能因素。
