Shear wave elastography imaging in the assessment of skin stiffness in Egyptian patients with systemic sclerosis/scleroderma

Background : The modified Rodnan skin score (mRSS) is a commonly used tool for the evaluation of skin involvement in scleroderma patients, however, it has many fallacies such as low objectivity and lack of inter-observer. In recent years, shear-wave elastography (SWE) proved to be an important assessment tool in the quantification of skin involvement in systemic sclerosis patients. In this study, we aimed to evaluate ultrasound and elastography findings in patients with systemic sclerosis and to clarify the effectiveness of elastosonography in the assessment of disease severity. Methods: This prospective analytical study was conducted on 25 clinically diagnosed patients of scleroderma who subjected to shear wave elastography referred from Rheumatology and Rehabilitation Department, Faculty of Medicine, in our University to the Diagnostic Radiology department, they were compared with 25 age and sex matched healthy controls. Results: High statistically significant difference (p-value < 0.001) was found in skin stiffness by elastography in cases group (median = 15 and inter-quartile range (IQR) = 11 – 21.5) when compared with control group (median = 10.5, IQR = 9.5 – 11.5), there was discrimination between cases group and control group was at a cut off level of > 13.6, with 58% sensitivity, 94% specificity. Conclusions: The shear wave elastography helped in early skin stiffness detection and assessment in scleroderma/systemic sclerosis patients, with less influence of clinical features and greater sensitivity and specificity.