Osteolysis in Systemic Sclerosis: A Scoping Review

Miguel Gomes Guerra; Mariana Rodrigues; Ana Águeda; Joana Rodrigues; José Marona; António Violante; Margarida Oliveira

doi:10.3899/jrheum.220626

Osteolysis in Systemic Sclerosis: A Scoping Review

J Rheumatol. 2023 Jul;50(7):863-872. doi: 10.3899/jrheum.220626. Epub 2023 Feb 1.

Authors

Miguel Gomes Guerra¹, Mariana Rodrigues², Ana Águeda³, Joana Rodrigues³, José Marona³, António Violante³, Margarida Oliveira⁴

Affiliations

¹ M.G. Guerra, MD, A. Águeda, MD, J. Rodrigues, MD, J. Marona, MD, A. Violante, MD, Rheumatology Department, Centro Hospitalar Universitário Cova da Beira; mlgomesg@gmail.com.
² M. Rodrigues, MD, Faculty of Health Sciences, Universidade da Beira Interior.
³ M.G. Guerra, MD, A. Águeda, MD, J. Rodrigues, MD, J. Marona, MD, A. Violante, MD, Rheumatology Department, Centro Hospitalar Universitário Cova da Beira.
⁴ M. Oliveira, MD, Rheumatology Department, Centro Hospitalar Universitário Cova da Beira, and Faculty of Health Sciences, Universidade da Beira Interior, Covilhã, Portugal.

PMID: 36725053
DOI: 10.3899/jrheum.220626

Abstract

Objective: To perform a scoping review focusing on osteolysis in systemic sclerosis (SSc).

Methods: This review was performed in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) recommendations.

Results: From a total of 351 results, 29 articles were included for the final analysis. The publications included proved to be heterogeneous regarding the population and inclusion criteria. The lack of a standardized method of detection of osteolysis further enhanced these inequalities. Most studies reported location/prevalence of osteolysis and associations with other manifestations, with only a minority focusing on topics like predictors of osteolysis and its prognostic value. None of the authors addressed treatment approach. The most frequently analyzed and prevalent location was acro-osteolysis (AO). Diffuse cutaneous subtype and anti-topoisomerase I antibody correlated positively with AO. Disease duration, calcinosis, and digital ischemia were the features more frequently associated with AO, but only the last 2 predicted AO. Ultrasound showed high sensitivity for detection of AO.

Conclusion: Despite the effect that osteolysis has on patients with SSc, there is a significant lack of studies on this area. Notably, there are no studies that we know of focused on treatment. Also, there is a lack of longitudinal studies that would allow a reliable assessment of its prognostic value and predictors.

Keywords: osteolysis; review; systemic sclerosis.

Publication types

Review

MeSH terms

Acro-Osteolysis* / complications
Humans
Osteolysis* / diagnostic imaging
Osteolysis* / etiology
Scleroderma, Systemic* / complications
Skin