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Journal of Clinical Rheumatology :... Apr 2023
Topics: Humans; Acro-Osteolysis; Fingers
PubMed: 36870083
DOI: 10.1097/RHU.0000000000001943 -
Clinical Rheumatology Jan 2017Acro-osteolysis is an osteolysis of the distal phalanges of the hands and feet and can affect the terminal tuft or the shaft of the distal phalanx (transverse or band... (Review)
Review
Acro-osteolysis is an osteolysis of the distal phalanges of the hands and feet and can affect the terminal tuft or the shaft of the distal phalanx (transverse or band acro-osteolysis). It is often associated with distal digital ischemia, digital calcinosis, or severe sensory neuropathy. Acro-osteolysis has been associated with a heterogeneous group of disorders, including occupational activities, infections, rheumatic disorders (systemic sclerosis, psoriatic arthritis), endocrinopathies, genetic disorders, and lysosomal storage disorders. Plain radiography is the gold standard for the detection of acro-osteolysis.
Topics: Acro-Osteolysis; Finger Phalanges; Fingers; Hajdu-Cheney Syndrome; Hand; Humans; Hyperparathyroidism; Ischemia; Leprosy; Lysosomal Storage Diseases; Mutation; Osteolysis; Rheumatic Diseases; Rheumatology; Scleroderma, Systemic
PubMed: 27796661
DOI: 10.1007/s10067-016-3459-7 -
European Journal of Rheumatology Apr 2019
PubMed: 30308144
DOI: 10.5152/eurjrheum.2018.18087 -
BMJ Case Reports Mar 2021Sarcoidosis is characterised by the formation of noncaseating granulomas classically affecting lungs, lymph nodes and skin. Osteoarticular involvement affects up to 15%...
Sarcoidosis is characterised by the formation of noncaseating granulomas classically affecting lungs, lymph nodes and skin. Osteoarticular involvement affects up to 15% of patients; however, acro-osteolysis, destruction involving distal phalanges of fingers and toes, associated with sarcoidosis, is extremely rare. A 44-year-old woman with a history of biopsy-proven sarcoidosis managed with prednisone and methotrexate presented with swelling and pain in the distal fingers of her right hand without skin manifestations. Radiographic imaging showed erosion of distal phalanges on second, third and fifth fingers and bone resorption in bilateral toes. A biopsy of the finger lesions showed noncaseating granulomas consistent with sarcoidosis. She was diagnosed with sarcoid acro-osteolysis and started on adalimumab with clinical and radiographic improvement. While most cases of osteoarticular sarcoidosis are asymptomatic and respond to standard immunosuppression, we present a case with progressive and refractory clinical course. This is the first reported case of sarcoid acro-osteolysis affecting the toes.
Topics: Acro-Osteolysis; Adult; Female; Fingers; Hand; Humans; Sarcoidosis; Toes
PubMed: 33653863
DOI: 10.1136/bcr-2020-240828 -
Current Opinion in Rheumatology Nov 2018To provide an update on the available literature regarding the epidemiology, pathophysiology, diagnosis, and treatment of calcinosis cutis in patients with systemic... (Review)
Review
PURPOSE OF REVIEW
To provide an update on the available literature regarding the epidemiology, pathophysiology, diagnosis, and treatment of calcinosis cutis in patients with systemic sclerosis (SSc).
RECENT FINDINGS
We identified observational studies that describe the frequency of calcinosis in SSc and associated clinical features; molecular studies exploring potential pathogenic mechanisms; and case reports and case series describing new diagnostic approaches and treatments.
SUMMARY
Calcinosis cutis is the deposition of insoluble calcium in the skin and subcutaneous tissues. It represents a major clinical problem in patients with SSc affecting at least one quarter of patients. It is associated with longer disease duration, digital ulcers, acro-osteolysis, positive anticentromere antibody, and positive anti-PM/Scl antibody. Although pathogenesis is unknown, there is evidence supporting local trauma, chronic inflammation, vascular hypoxia, and dysregulation of bone matrix proteins as potential mechanisms. Diagnosis can be made clinically or with plain radiography. Several pharmacologic therapies have been tried for calcinosis with variable and modest results, but surgical excision of calcium deposits remains the mainstay of treatment.
Topics: Calcinosis; Calcium; Global Health; Humans; Incidence; Scleroderma, Systemic; Skin
PubMed: 30124603
DOI: 10.1097/BOR.0000000000000539 -
Mayo Clinic Proceedings Oct 2023
Topics: Humans; Acro-Osteolysis; Fingers
PubMed: 37793727
DOI: 10.1016/j.mayocp.2023.05.015 -
Skeletal Radiology Jan 2023Acro-osteolysis is the osseous destruction of the hand or foot distal phalanges. The categories of the disease include terminal tuft, midshaft, or mixed types.... (Review)
Review
Acro-osteolysis is the osseous destruction of the hand or foot distal phalanges. The categories of the disease include terminal tuft, midshaft, or mixed types. Recognition of acro-osteolysis is straightforward on radiographs, but providing an accurate differential diagnosis and appropriately recommending advanced imaging or invasive tissue diagnosis can be more elusive. A radiologist's ability to provide advanced assessment can greatly aid clinicians in expedient diagnosis and management of the array of diseases presenting with acro-osteolysis.
Topics: Humans; Diagnosis, Differential; Acro-Osteolysis; Finger Phalanges; Hand; Radiography; Osteolysis
PubMed: 35969258
DOI: 10.1007/s00256-022-04145-y -
ACR Open Rheumatology Oct 2019
PubMed: 31777834
DOI: 10.1002/acr2.11072 -
Clinical Rheumatology Jul 2024
Topics: Humans; Acro-Osteolysis; Scleroderma, Systemic; Female; Middle Aged; Radiography
PubMed: 38767709
DOI: 10.1007/s10067-024-06988-3 -
QJM : Monthly Journal of the... Feb 2022
Topics: Acro-Osteolysis; Calcinosis; Humans; Scleroderma, Systemic
PubMed: 34963011
DOI: 10.1093/qjmed/hcab331