{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:46:43Z","timestamp":1759452403140,"version":"build-2065373602"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T00:00:00Z","timestamp":1647388800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Systemic sclerosis (SSc) is an autoimmune connective tissue disorder characterized by skin fibrosis, vasculopathy, and dysimmunity. Data regarding osteitis in SSc are scarce.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a nationwide multicenter, retrospective, case\u2013control study including patients with SSc, according to the 2013 American College of Rheumatology\/European Alliance of Associations for Rheumatology classification, with a diagnosis of osteitis. The objectives of the study were to describe, to characterize, and to identify associated factors for osteitis in patients with SSc.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010eight patients were included. Twenty\u2010six patients (54.1%) had osteitis beneath digital tip ulcers. Physical symptoms included pain (36 of 48, 75%), erythema (35 of 48, 73%), and local warmth (35 of 48, 73%). Thirty\u2010one (65%) patients had median (interquartile range) C\u2010reactive protein levels &gt;2 mg\/liter of 8 (2.7\u201344.3) mg\/liter. On radiography, computed tomography, or magnetic resonance imaging, osteitis was characterized by swelling or abscess of soft tissues, with acro\u2010osteolysis or lysis in 28 patients (58%). Microbiological sampling was performed in 45 (94%) patients. Most pathogens were <jats:italic>Staphylococcus aureus<\/jats:italic> (43.8%), anaerobes and Enterobacteriaceae (29.1%), and <jats:italic>Pseudomonas aeruginosa<\/jats:italic> (10.4%). 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 plus \u03b2\u2010lactamase inhibitor in 7 (14.6%). Six (12.6%) patients relapsed, 6 (12.6%) patients had osteitis recurrence, 15 (32%) sequelae, and 2 patients had septic shock and died.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study confirmed digital tip ulcers as an associated factor for osteitis and revealed a high rate of functional sequelae. Antimicrobial therapy with oral fluoroquinolone or intravenous amoxicillin and \u03b2\u2010lactamase inhibitor are used as first\u2010line antibiotic therapy in SSc patients with osteitis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.24530","type":"journal-article","created":{"date-parts":[[2020,12,5]],"date-time":"2020-12-05T11:54:48Z","timestamp":1607169288000},"page":"809-817","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Osteitis in Systemic Sclerosis: A Nationwide Case\u2013Control Retrospective Study"],"prefix":"10.1002","volume":"74","author":[{"given":"Cyril","family":"Cosse","sequence":"first","affiliation":[{"name":"Service de M\u00e9decine Interne, Centre de R\u00e9f\u00e9rence Maladies Syst\u00e9miques Auto\u2010Immunes Rares d'Ile de France, H\u00f4pital Cochin, Universit\u00e9 Paris Descartes, Assistance Publique\u2010H\u00f4pitaux de Paris  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Solen","family":"Kern\u00e9is","sequence":"additional","affiliation":[{"name":"Assistance Publique\u2010H\u00f4pitaux de Paris, Cochin Hospital University of Paris  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2081-8558","authenticated-orcid":false,"given":"Alain","family":"Lescoat","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Rennes, CHU Rennes, Inserm, EHESP, Institut de Recherche en Sant\u00e9, Environnement et Travail, UMR S 1085, and Department of Internal Medicine and Clinical Immunology, Rennes University Hospital  Rennes France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Pugnet","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Interne CHU Toulouse, and Centre d'Investigation Clinique 1436, CHU Toulouse  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie\u2010Elise","family":"Truchetet","sequence":"additional","affiliation":[{"name":"Rheumatology Department and National Center of Reference for Rare Autoimmune Diseases Bordeaux University Hospital  Bordeaux France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pascal","family":"Priollet","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Vasculaire, H\u00f4pital Saint Joseph  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth","family":"Diot","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Interne, H\u00f4pital Bretonneau  Tours France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mickael","family":"Martin","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Interne, Maladies Infectieuses et Tropicales, CHU de Poitiers  Poitiers France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3222-8566","authenticated-orcid":false,"given":"Fran\u00e7ois","family":"Maurier","sequence":"additional","affiliation":[{"name":"Centre de Comp\u00e9tence des Maladies Rares, H\u00f4pitaux priv\u00e9s de Metz  Metz France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean Fran\u00e7ois","family":"Viallard","sequence":"additional","affiliation":[{"name":"D\u00e9partement de M\u00e9decine Interne et Maladies Infectieuses Centre Hospitalier Universitaire Haut L\u00e9v\u00eaque, Universit\u00e9 de Bordeaux  Pessac France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Agard","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Interne, H\u00f4tel\u2010Dieu, CHU Nantes, H\u00f4pital Universit\u00e9 de Nantes  Nantes France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7995-8817","authenticated-orcid":false,"given":"Brigitte","family":"Granel","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Interne, H\u00f4pital Nord, Aix\u2010Marseille Universit\u00e9, Assistance Publique\u2010H\u00f4pitaux de Marseille  Marseille France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabine","family":"Berthier","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Interne et Immunologie Clinique, CHU F. 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