{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T13:59:36Z","timestamp":1778075976245,"version":"3.51.4"},"reference-count":45,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T00:00:00Z","timestamp":1710720000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Patients with immune-mediated rheumatic disease-related calcinosis comprise a subgroup at risk of encountering a more severe clinical outcome. Early assessment is pivotal for preventing overall disease progression, as calcinosis is commonly overlooked until several years into the disease and is considered as a \u2018non-lethal\u2019 manifestation. This single-center retrospective study explored the prevalence, clinical associations, and impact on survival of subcutaneous calcinosis in 86 patients with immune-mediated rheumatic diseases (IMRD). Calcinosis predominantly appeared in individuals with longstanding disease, particularly systemic sclerosis (SSc), constituting 74% of cases. Smaller calcinosis lesions (\u22641 cm) were associated with interstitial lung disease, musculoskeletal involvement, and digital ulcerations, while larger lesions (\u22654 cm) were associated with malignancy, severe peripheral artery disease, and systemic arterial hypertension. The SSc calcinosis subgroup exhibited a higher mean adjusted European Scleroderma Study Group Activity Index score than those without. However, survival rates did not significantly differ between the two groups. Diltiazem was the most commonly used treatment, and while bisphosphonates reduced complications related to calcinosis, complete resolution was not achieved. The findings underscore current limitations in diagnosing, monitoring, and treating calcinosis, emphasizing the need for further research and improved therapeutic strategies to improve patient care and outcomes.<\/jats:p>","DOI":"10.3390\/diagnostics14060637","type":"journal-article","created":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T06:58:39Z","timestamp":1710745119000},"page":"637","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Calcinosis in Rheumatic Disease Is Still an Unmet Need: A Retrospective Single-Center Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Cristina","family":"Nita","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, \u2018Sfanta Maria\u2019 Clinical Hospital, 011172 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4175-1199","authenticated-orcid":false,"given":"Laura","family":"Groseanu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, \u2018Sfanta Maria\u2019 Clinical Hospital, 011172 Bucharest, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u2018Carol Davila\u2019, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3883-9672","authenticated-orcid":false,"given":"Daniela","family":"Opris","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, \u2018Sfanta Maria\u2019 Clinical Hospital, 011172 Bucharest, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u2018Carol Davila\u2019, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denisa","family":"Predeteanu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, \u2018Sfanta Maria\u2019 Clinical Hospital, 011172 Bucharest, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u2018Carol Davila\u2019, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Violeta","family":"Bojinca","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, \u2018Sfanta Maria\u2019 Clinical Hospital, 011172 Bucharest, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u2018Carol Davila\u2019, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3405-9273","authenticated-orcid":false,"given":"Florian","family":"Berghea","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, \u2018Sfanta Maria\u2019 Clinical Hospital, 011172 Bucharest, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u2018Carol Davila\u2019, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Violeta","family":"Vlad","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, \u2018Sfanta Maria\u2019 Clinical Hospital, 011172 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihai","family":"Abobului","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, \u2018Sfanta Maria\u2019 Clinical Hospital, 011172 Bucharest, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u2018Carol Davila\u2019, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cosmin","family":"Constantinescu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, \u2018Sfanta Maria\u2019 Clinical Hospital, 011172 Bucharest, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u2018Carol Davila\u2019, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena","family":"Negru","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, \u2018Sfanta Maria\u2019 Clinical Hospital, 011172 Bucharest, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u2018Carol Davila\u2019, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioana","family":"Saulescu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, \u2018Sfanta Maria\u2019 Clinical Hospital, 011172 Bucharest, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u2018Carol Davila\u2019, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanziana","family":"Daia","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, \u2018Sfanta Maria\u2019 Clinical Hospital, 011172 Bucharest, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u2018Carol Davila\u2019, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1342-3243","authenticated-orcid":false,"given":"Diana","family":"Mazilu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, \u2018Sfanta Maria\u2019 Clinical Hospital, 011172 Bucharest, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u2018Carol Davila\u2019, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreea","family":"Borangiu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, \u2018Sfanta Maria\u2019 Clinical Hospital, 011172 Bucharest, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u2018Carol Davila\u2019, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Cobilinschi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, \u2018Sfanta Maria\u2019 Clinical Hospital, 011172 Bucharest, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u2018Carol Davila\u2019, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denisse","family":"Mardale","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, \u2018Sfanta Maria\u2019 Clinical Hospital, 011172 Bucharest, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u2018Carol Davila\u2019, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madalina","family":"Rosu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, \u2018Sfanta Maria\u2019 Clinical Hospital, 011172 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andra","family":"Balanescu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, \u2018Sfanta Maria\u2019 Clinical Hospital, 011172 Bucharest, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u2018Carol Davila\u2019, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,18]]},"reference":[{"key":"ref_1","unstructured":"Le, C., and Bedocs, P.M. (2023). StatPearls, StatPearls Publishing."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"980","DOI":"10.3899\/jrheum.211393","article-title":"Management of Calcinosis Cutis in Rheumatic Diseases","volume":"49","author":"Elahmar","year":"2022","journal-title":"J. Rheumatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2148","DOI":"10.1093\/rheumatology\/kew313","article-title":"Calcinosis is associated with digital ischaemia in systemic sclerosis\u2014A longitudinal study","volume":"55","author":"Baron","year":"2016","journal-title":"Rheumatology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1136\/ard.2010.134304","article-title":"Predictive factors of hand radiographic lesions in systemic sclerosis: A prospective study","volume":"70","author":"Avouac","year":"2011","journal-title":"Ann. Rheum. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.humpath.2005.10.007","article-title":"The differential expression of VEGF, VEGFR-2, and GLUT-1 proteins in disease subtypes of systemic sclerosis","volume":"37","author":"Davies","year":"2006","journal-title":"Hum. Pathol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"443","DOI":"10.3390\/immuno2030027","article-title":"Innate Immunity in Calcinosis Cutis","volume":"2","author":"Jiang","year":"2022","journal-title":"Immuno"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1093\/rheumatology\/kep078","article-title":"Myositis-specific autoantibodies: Their clinical and pathogenic significance in disease expression","volume":"48","author":"Gunawardena","year":"2009","journal-title":"Rheumatology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1093\/rheumatology\/kei277","article-title":"Expression of osteonectin and matrix Gla protein in scleroderma patients with and without calcinosis","volume":"45","author":"Davies","year":"2006","journal-title":"Rheumatology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1001\/archdermatol.2011.2052","article-title":"Calcinosis Cutis Occurring in Association with Autoimmune Connective Tissue Disease: The Mayo Clinic Experience with 78 Patients, 1996\u20132009","volume":"148","author":"Wetter","year":"2012","journal-title":"Arch. Dermatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1097\/BOR.0b013e32834ff5cd","article-title":"Soft tissue and subcutaneous calcification in connective tissue diseases","volume":"24","author":"Chander","year":"2012","journal-title":"Curr. Opin. Rheumatol."},{"key":"ref_11","first-page":"e8727","article-title":"Dystrophic Calcinosis Cutis in Systemic Lupus Erythematosus","volume":"12","author":"Achebe","year":"2020","journal-title":"Cureus"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"101768","DOI":"10.1016\/j.berh.2022.101768","article-title":"Calcinosis in dermatomyositis: Origins and possible therapeutic avenues","volume":"36","author":"Davuluri","year":"2022","journal-title":"Best Pract. Res. Clin. Rheumatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1111\/j.1529-8019.2012.01492.x","article-title":"Calcinosis cutis in autoimmune connective tissue diseases: Calcinosis cutis and connective tissue disease","volume":"25","author":"Gutierrez","year":"2012","journal-title":"Dermatol. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1111\/j.1346-8138.2002.tb00176.x","article-title":"Localized Linear Scleroderma with Cutaneous Calcinosis","volume":"29","author":"Yamamoto","year":"2002","journal-title":"J. Dermatol."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Mormile, I., Mosella, F., Turco, P., Napolitano, F., De Paulis, A., and Rossi, F.W. (2023). Calcinosis Cutis and Calciphylaxis in Autoimmune Connective Tissue Diseases. Vaccines, 11.","DOI":"10.3390\/vaccines11050898"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"151980","DOI":"10.1016\/j.semarthrit.2022.151980","article-title":"Change in calcinosis over 1 year using the scleroderma clinical trials consortium radiologic scoring system for calcinosis of the hands in patients with systemic sclerosis","volume":"53","author":"Valenzuela","year":"2022","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1002\/acr.22434","article-title":"Validation of a Novel Radiographic Scoring System for Calcinosis Affecting the Hands of Patients with Systemic Sclerosis: Novel Radiographic Scoring System for Calcinosis","volume":"67","author":"Chung","year":"2015","journal-title":"Arthritis Care Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/j.rdc.2023.01.017","article-title":"Patient Experience of Systemic Sclerosis\u2013Related Calcinosis","volume":"49","author":"Saketkoo","year":"2023","journal-title":"Rheum. Dis. Clin. N. Am."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2985","DOI":"10.1007\/s10067-020-05523-4","article-title":"Clinical and ultrasound response to intralesional sodium thiosulfate for the treatment of calcinosis cutis in the setting of systemic sclerosis. A case-based review","volume":"40","year":"2021","journal-title":"Clin. Rheumatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"102984","DOI":"10.1016\/j.amsu.2021.102984","article-title":"Systemic sclerosis cutaneous expression: Management of skin fibrosis and digital ulcers","volume":"71","author":"Starnoni","year":"2021","journal-title":"Ann. Med. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1002\/art.40930","article-title":"2019 European League Against Rheumatism\/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus","volume":"71","author":"Aringer","year":"2019","journal-title":"Arthritis Rheumatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1955","DOI":"10.1136\/annrheumdis-2017-211468","article-title":"2017 European League Against Rheumatism\/American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups","volume":"76","author":"Lundberg","year":"2017","journal-title":"Ann. Rheum. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1002\/art.39859","article-title":"2016 American College of Rheumatology\/European League Against Rheumatism Classification Criteria for Primary Sj\u00f6gren\u2019s Syndrome: A Consensus and Data-Driven Methodology Involving Three International Patient Cohorts","volume":"69","author":"Shiboski","year":"2017","journal-title":"Arthritis Rheumatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.1136\/annrheumdis-2013-204424","article-title":"2013 classification criteria for systemic sclerosis: An American college of rheumatology\/European league against rheumatism collaborative initiative","volume":"72","author":"Khanna","year":"2013","journal-title":"Ann. Rheum. Dis."},{"key":"ref_25","unstructured":"Kasukawa, R., and Sharp, G.C. (1986, January 29\u201330). Mixed Connective Tissue Disease and Anti-nuclear Antibodies. Proceedings of the International Symposium on Mixed Connective Tissue Disease and Anti-nuclear Antibodies, Tokyo, Japan. Excerpta Medica."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1016\/j.semarthrit.2005.01.016","article-title":"Calcinosis in Rheumatic Diseases","volume":"34","author":"Boulman","year":"2005","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/s10067-016-3412-9","article-title":"Clinical, biochemical, and radiological characterization of the calcinosis in a cohort of Mexican patients with systemic sclerosis","volume":"36","author":"Saavedra","year":"2017","journal-title":"Clin. Rheumatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1007\/s00403-021-02264-5","article-title":"Local, non-systemic, and minimally invasive therapies for calcinosis cutis: A systematic review","volume":"314","author":"Nowaczyk","year":"2022","journal-title":"Arch. Dermatol. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1093\/rheumatology\/kew193","article-title":"Calcinosis in systemic sclerosis: Subsets, distribution and complications","volume":"55","author":"Bartoli","year":"2016","journal-title":"Rheumatology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1177\/23971983211053245","article-title":"Subcutaneous calcinosis: Is it different between systemic sclerosis and dermatomyositis?","volume":"7","author":"Valenzuela","year":"2022","journal-title":"J. Scleroderma Relat. Disord."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1097\/RHU.0000000000000598","article-title":"Extensive Dystrophic Calcinosis Cutis: A Severe Complication of Polymyositis\/Systemic Sclerosis Overlap Syndrome","volume":"23","author":"Smith","year":"2017","journal-title":"JCR J. Clin. Rheumatol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e13319","DOI":"10.1097\/MD.0000000000013319","article-title":"Dystrophic calcinosis in a patient with overlap syndrome (scleroderma and rheumatoid arthritis) treated by leflunomide: A case report","volume":"97","author":"Lee","year":"2018","journal-title":"Medicine"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1177\/096120339900800608","article-title":"Prevalence of soft tissue calcifications in patients with SLE and effects of alfacarcidol","volume":"8","author":"Okada","year":"1999","journal-title":"Lupus"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1016\/j.semarthrit.2020.06.007","article-title":"Calcinosis is associated with ischemic manifestations and increased disability in patients with systemic sclerosis","volume":"50","author":"Valenzuela","year":"2020","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1080\/14397595.2021.1886654","article-title":"Prevalence and clinical association with calcinosis cutis in early systemic sclerosis","volume":"31","author":"Muktabhant","year":"2021","journal-title":"Mod. Rheumatol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1080\/14397595.2017.1349594","article-title":"Are there risk factors for scleroderma-related calcinosis?","volume":"28","author":"Pai","year":"2018","journal-title":"Mod. Rheumatol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3636","DOI":"10.1093\/rheumatology\/keac682","article-title":"Cumulative disease damage and anti-PM\/Scl antibodies are associated with a heavy burden of calcinosis in systemic sclerosis","volume":"62","author":"Richardson","year":"2022","journal-title":"Rheumatology"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1093\/rheumatology\/keaa332","article-title":"High proton pump inhibitor exposure increases risk of calcinosis in systemic sclerosis","volume":"60","author":"Host","year":"2021","journal-title":"Rheumatology"},{"key":"ref_39","unstructured":"(2023, October 06). Calcinosis in Poly-Dermatomyositis: Clinical and Laboratory Predictors and Treatment Options. Available online: https:\/\/www.clinexprheumatol.org\/abstract.asp?a=10801."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1007\/s11926-014-0467-y","article-title":"The Presentation, Assessment, Pathogenesis, and Treatment of Calcinosis in Juvenile Dermatomyositis","volume":"16","author":"Hoeltzel","year":"2014","journal-title":"Curr. Rheumatol. Rep."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1002\/art.38428","article-title":"Clinical and Serologic Correlates of Anti-PM\/Scl Antibodies in Systemic Sclerosis: A Multicenter Study of 763 Patients: Anti-PM-1\u03b1 Antibodies and SSc Clinical Phenotype","volume":"66","author":"Hudson","year":"2014","journal-title":"Arthritis Rheumatol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e22443","DOI":"10.1097\/MD.0000000000022443","article-title":"Relationship between calcifications and structural lesions on hand radiography and axial calcifications on CT-scan: A retrospective study in systemic sclerosis","volume":"99","author":"Bauer","year":"2020","journal-title":"Medicine"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1080\/25785826.2020.1754692","article-title":"\u2018Narrow-sense\u2019 and \u2018broad-sense\u2019 vascular abnormalities of systemic sclerosis","volume":"43","author":"Jinnin","year":"2020","journal-title":"Immunol. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"3109","DOI":"10.1093\/rheumatology\/keaa131","article-title":"A pilot study of cutaneous oxygenation and perfusion in systemic sclerosis\u2013related digital calcinosis","volume":"59","author":"Manning","year":"2020","journal-title":"Rheumatology"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1002\/art.40799","article-title":"Ulnar Artery Occlusion and Severity Markers of Vasculopathy in Systemic Sclerosis: A Multicenter Cross-Sectional Study","volume":"71","author":"Lescoat","year":"2019","journal-title":"Arthritis Rheumatol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/6\/637\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:15:08Z","timestamp":1760105708000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/6\/637"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,18]]},"references-count":45,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,3]]}},"alternative-id":["diagnostics14060637"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics14060637","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,18]]}}}