Systemic sclerosis (SSc) is an autoimmune (AI) connective tissue disorder characterized by skin fibrosis, vasculopathy, and dysimmunity. Data regarding osteitis in SSc are scarce. We performed a nationwide multicentre retrospective case‐control study, including patients with SSc according to the 2013 ACR/EULAR classification, with osteitis diagnosis. The objectives of this study were to identify, characterize, and describe associated factors for osteitis in SSc patients.
Forty‐eight patients were included. Thirty‐one (65%) patients had C‐reactive protein levels >2 mg/L (8 [2.7 – 44.3] mg/L). On MRI, CT‐scans, or X‐ray, osteitis was characterized by abscess or swelling of soft tissues with acro‐osteolysis or lysis in 28 patients (58%). Microbiological sampling was performed in 45 (94%) patients. Management comprised antibiotics in 37 (77.1%) patients and/or surgery in 26 (54.2%). Fluoroquinolones were used in 22 (45.8%) patients and amoxicillin + beta‐lactamase inhibitors in 7 (14.6%). Six (12.6%) patients relapsed, 6 (12.6%) patients had osteitis recurrence, 15 (32%) sequelae, and two patients had septic shock and died.
In conclusion, this study revealed a high functional sequelae rate and confirmed the digital tip ulcers as an associated factor for osteitis and. Antimicrobial therapy with an intravenous amoxicillin or oral fluoroquinolone and beta‐lactamase inhibitor is used as the first‐line antibiotherapy in SSc patients with osteitis.
Ref: https://onlinelibrary.wiley.com/doi/10.1002/acr.24530
