{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T13:24:39Z","timestamp":1767965079719,"version":"3.49.0"},"reference-count":16,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T00:00:00Z","timestamp":1627344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100001845","name":"Scleroderma Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001845","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the ability of ultrasound (US) compared to radiographs to detect calcinosis in hands\/wrists of patients with systemic sclerosis (SSc), and to assess US markers of pathologic perfusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with SSc were evaluated for\u00a0calcinosis\u00a0in the hands\/wrists by radiograph and US. The presence or absence of\u00a0calcinosis\u00a0was recorded by patient, hand, and anatomic zone; sensitivity and specificity for\u00a0calcinosis\u00a0detection\u00a0by US versus radiographs was determined. Bilateral US vascular measurements of\u00a0ulnar\u00a0artery\u00a0occlusion\u00a0(UAO) and finger pulp blood flow (FPBF) were obtained. For each hand, associations between markers of pathologic blood flow (UAO, FPBF, and a composite severity score of UAO and FPBF) and the presence of\u00a0calcinosis\u00a0were assessed using generalized estimating equations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 43 patients with SSc (19 diffuse, 24 limited), 39.5% had calcinosis on radiographs compared to 30.2% on US. Sensitivity and specificity for US, respectively, were 61% and 95% by zone, 78% and 98% by hand, and 76% and 100% by patient. UAO was seen in 30% and 28% of left and right hands, respectively; FPBF was absent in \u22651 digit of the left and right hands in 49% and 44%, respectively. UAO was associated with radiograph\u2010identified calcinosis by hand (odds ratio [OR] 8.08 [95% confidence interval (95% CI) 2.45\u201326.60], <jats:italic>P<\/jats:italic> &lt; 0.001), whereas FPBF and the composite severity score were not significant. UAO was associated with calcinosis even in the absence of digital ulcers (OR 33.00 [95% CI 3.39\u2013321.09], <jats:italic>P<\/jats:italic> = 0.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>US was sensitive and highly specific in detecting calcinosis in SSc. UAO was strongly associated with radiograph\u2010identified calcinosis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.24327","type":"journal-article","created":{"date-parts":[[2020,5,31]],"date-time":"2020-05-31T08:53:01Z","timestamp":1590915181000},"page":"1332-1337","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Ultrasound Detection of Calcinosis and Association With Ulnar Artery Occlusion in Patients With Systemic Sclerosis"],"prefix":"10.1002","volume":"73","author":[{"given":"Robert","family":"Fairchild","sequence":"first","affiliation":[{"name":"Stanford University School of Medicine  Palo Alto California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0221-4910","authenticated-orcid":false,"given":"Melody","family":"Chung","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine  Palo Alto California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurel","family":"Sharpless","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine  Palo Alto California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shufeng","family":"Li","sequence":"additional","affiliation":[{"name":"Stanford University Medical Center  Palo Alto California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorinda","family":"Chung","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine and Veterans Administration Palo Alto Health Care System  Palo Alto California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,7,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2006.07.004"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2016.05.008"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2005.01.016"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e32834ff5cd"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kew313"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.2217\/ijr.10.17"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23413"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker414"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22965"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.40799"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.13121994"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-019-1875-1"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kex045"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.38098"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22434"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kes214"}],"container-title":["Arthritis Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.24327","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/acr.24327","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.24327","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T16:51:59Z","timestamp":1759423919000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr.24327"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,27]]},"references-count":16,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1002\/acr.24327"],"URL":"https:\/\/doi.org\/10.1002\/acr.24327","archive":["Portico"],"relation":{},"ISSN":["2151-464X","2151-4658"],"issn-type":[{"value":"2151-464X","type":"print"},{"value":"2151-4658","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,27]]},"assertion":[{"value":"2020-01-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}