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In patients with connective tissue diseases (CTD), ultrasonography (US) allows the detection of a wide range of morphostructural changes not only at musculoskeletal system level, but also at other target tissues including skin, lung, and salivary glands.

Synovitis, joint dislocation, bone erosion, and cartilage damage can be detected while scanning patients with systemic lupus erythematosus. In particular, cartilage damage and bone erosions are more frequently found in Rhupus syndrome, while joint dislocation is more common in Jaccoud’s arthropathy. US can also reveal inflammatory changes in non-synovial areas, such as tendons with no synovial sheath and their entheses.

Very-high-frequency probes offer the possibility to assess skin thickness and echogenicity in patients with systemic sclerosis. The degree of skin involvement is a very important outcome measure in systemic sclerosis. Other US findings in systemic sclerosis include soft tissue calcifications and narrowing of the distance between phalangeal apex and skin surface at the distal finger level.

In patients with Sjögren’s syndrome, the main US abnormalities at salivary glands include parenchymal inhomogeneity, hypoanechoic or hyperechoic areas, increased or reduced size, irregularity of the margins, and presence of peri-intraglandular lymph nodes.

Finally, US findings in CTD-interstitial lung disease (ILD) include B-lines and pleural irregularities.

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Carotti, M., Filippucci, E., Salaffi, F., Martino, F. (2022). Connective Tissue Disorders. In: Martino, F., Silvestri, E., Orlandi, D. (eds) Musculoskeletal Ultrasound in Orthopedic and Rheumatic disease in Adults. Springer, Cham.

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