{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T23:07:24Z","timestamp":1791414444095,"version":"4.3.3"},"reference-count":33,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2022,9,3]],"date-time":"2022-09-03T00:00:00Z","timestamp":1662163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple organs and organ systems. Musculoskeletal (MSK) involvement is one of the most frequent and the earliest locations of disease. This disease affects joints and periarticular soft tissues, tendon sheaths and tendons, bones, and muscles. Multimodality imaging, including radiography, ultrasound (US), and magnetic resonance imaging (MRI), plays a significant role in the initial evaluation and treatment follow up of MSK manifestations of the SLE. In this paper, we illustrate MSK imaging features in three clinical forms of SLE, including nondeforming nonerosive arthritis, deforming nonerosive arthropathy, and erosive arthropathy, as well as the other complications and features of SLE within the MSK system in adults and juveniles. Advances in imaging are included. Conventional radiography primarily shows late skeletal lesions, whereas the US and MRI are valuable in the diagnosis of the early inflammatory changes of the soft tissues and bone marrow, as well as late skeletal manifestations. In nondeforming nonerosive arthritis, US and MRI show effusions, synovial and\/or tenosynovial hypertrophy, and vascularity, whereas radiographs are normal. Deforming arthritis clinically resembles that observed in rheumatoid arthritis, but it is reversible, and US and MRI show features of inflammation of periarticular soft tissues (capsule, ligaments, and tendons) without the pannus and destruction classically observed in RA. Erosions are rarely seen, and this form of disease is called rhupus syndrome.<\/jats:p>","DOI":"10.3390\/jcm11175212","type":"journal-article","created":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T20:52:51Z","timestamp":1662497571000},"page":"5212","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Update on Current Imaging of Systemic Lupus Erythematous in Adults and Juveniles"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2671-3036","authenticated-orcid":false,"given":"Iwona","family":"Sudo\u0142-Szopi\u0144ska","sequence":"first","affiliation":[{"name":"Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewa","family":"\u017belnio","sequence":"additional","affiliation":[{"name":"Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marzena","family":"Olesi\u0144ska","sequence":"additional","affiliation":[{"name":"Connective Tissue Disease Department, Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Gietka","sequence":"additional","affiliation":[{"name":"Clinic of Paediatric Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylwia","family":"Ornowska","sequence":"additional","affiliation":[{"name":"Connective Tissue Disease Department, Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah Jane","family":"Power","sequence":"additional","affiliation":[{"name":"Catalina Pointe Arthritis & Rheumatology Specialists, P.C. 7520 North Oracle Road, Suite 100, Tucson, AZ 85704, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihra S.","family":"Taljanovic","sequence":"additional","affiliation":[{"name":"Departments of Medical Imaging and Orthopaedic Surgery, University of Arizona, Tucson, AZ 85719, USA"},{"name":"Department of Radiology, University of New Mexico, Albuquerque, NM 87131, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1590\/S0100-39842011000100013","article-title":"Imaging findings of musculoskeletal disorders associated with systemic lupus erythematosus","volume":"44","author":"Ribeiro","year":"2011","journal-title":"Radiol. Bras."},{"key":"ref_2","first-page":"e926436","article-title":"Comparison of Role of Hand and Wrist Ultrasound in Diagnosis of Subclinical Synovitis in Patients with Systemic Lupus Erythematosus and Rheumatoid Arthritis: A Retrospective, Single-Center Study","volume":"26","author":"Honghu","year":"2020","journal-title":"Med. Sci. Monit."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.semarthrit.2017.03.022","article-title":"Joint involvement in systemic lupus erythematosus: From pathogenesis to clinical assessment","volume":"47","author":"Ceccarelli","year":"2017","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e000264","DOI":"10.1136\/lupus-2018-000264","article-title":"Measuring lupus arthritis activity using contrasted high-field MRI. Associations with clinical measures of disease activity and novel patterns of disease","volume":"5","author":"Zollars","year":"2018","journal-title":"Lupus Sci. Med."},{"key":"ref_5","unstructured":"Greenspan, A., and Gershwin, A.E. (2018). Connective tissue arthropathies. Systemic lupus erythematosus. Imaging in Rheumatology, Wolters Kluwer."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Weisman, B.N. (2009). Systemic lupus erythematosus and related conditions and vasculitis syndrome. Imaging of Arthritis and Metabolic Bone Disease, Elsevier.","DOI":"10.1016\/B978-0-323-04177-5.00022-7"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1093\/rheumatology\/ket376","article-title":"Ultrasound evaluation of hand, wrist and foot joint synovitis in systemic lupus erythematosus","volume":"53","author":"Iagnocco","year":"2013","journal-title":"Rheumatology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1177\/0961203320947149","article-title":"Prevalence of subclinical synovitis of the hand in patients with systemic lupus erythematosus","volume":"29","year":"2020","journal-title":"Lupus"},{"key":"ref_9","unstructured":"Sudo\u0142-Szopi\u0144ska, I., Matuszewska, G., and Praco\u0144, G. (2022). Radiographic Atlas of Inflammatory Rheumatic Diseases, Medisfera."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1055\/s-0041-1729150","article-title":"Rheumatoid Hand and Other Hand-deforming Rheumatic Conditions","volume":"25","author":"Teh","year":"2021","journal-title":"Semin. Musculoskelet. Radiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1055\/s-0041-1726014","article-title":"Conventional Radiography and Ultrasound Imaging of Rheumatic Diseases Affecting the Pediatric Population","volume":"25","author":"Simoni","year":"2021","journal-title":"Semin. Musculoskelet. Radiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1136\/hrt.12.2.101","article-title":"The relation between heart and joint disease including \u201crheumatoid heart disease\u201d and chronic post-rheumatic arthritis (type Jaccoud)","volume":"12","author":"Bywaters","year":"1950","journal-title":"Br. Heart J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1136\/ard.57.9.540","article-title":"Deforming arthropathy or lupus and rhupus hands in systemic lupus erythematosus","volume":"57","author":"Derksen","year":"1998","journal-title":"Ann. Rheum. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1186\/s13075-016-1125-8","article-title":"Ultrasonographic assessment of bone erosions in the different subtypes of systemic lupus erythematosus arthritis: Comparison with computed tomography","volume":"18","author":"Piga","year":"2016","journal-title":"Arthritis Res. Ther."},{"key":"ref_15","first-page":"252","article-title":"The EFSUMB Guidelines and Recommendations for Musculoskeletal Ultrasound\u2014Part II: Joint Pathologies, Pediatric Applications, and Guided Procedures","volume":"43","author":"Naredo","year":"2021","journal-title":"Ultraschall Med. Eur. J. Ultrasound"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"5194","DOI":"10.1093\/rheumatology\/keab288","article-title":"Ultrasound to identify systemic lupus erythematosus patients with musculoskeletal symptoms who respond best to therapy: The US Evaluation For mUsculoskeletal Lupus longitudinal multicentre study","volume":"60","author":"Mahmoud","year":"2021","journal-title":"Rheumatology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1055\/s-0033-1335205","article-title":"EFSUMB Guidelines and Recommendations on the Clinical Use of Ultrasound Elastography. Part 1: Basic Principles and Technology","volume":"34","author":"Bamber","year":"2013","journal-title":"Ultraschall Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1177\/0961203309351729","article-title":"Spontaneous tendon rupture in systemic lupus erythematosus: Association with Jaccoud\u2019s arthropathy","volume":"19","author":"Alves","year":"2010","journal-title":"Lupus"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1055\/s-0038-1641572","article-title":"Myositis and fasciitis: Role of imaging","volume":"22","author":"Endo","year":"2018","journal-title":"Semin. Musculoskelet. Radiol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Di Matteo, A., Smerilli, G., Cipolletta, E., Wakefield, R.J., De Angelis, R., Risa, A.M., Salaffi, F., Farah, S., Villota-Eraso, C., and Maccarrone, V. (2022). Muscle involvement in systemic lupus erythematosus: Multimodal ultrasound assessment and relationship with physical performance. Rheumatology, keac196.","DOI":"10.1093\/rheumatology\/keac196"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.clinimag.2019.07.006","article-title":"Novel diagnostic imaging features of facial lupus panniculitis: Ultrasound, CT, and MR imaging with histopathology correlate","volume":"58","author":"Kimball","year":"2019","journal-title":"Clin. Imaging"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"449","DOI":"10.2174\/1874325001206010449","article-title":"Glucocorticoid-Induced Avascular Bone Necrosis: Diagnosis and Management","volume":"6","author":"Chan","year":"2012","journal-title":"Open Orrthop. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2044","DOI":"10.1002\/art.21110","article-title":"Prevalence of and risk factors for low bone mineral density and vertebral fractures in patients with systemic lupus erythematosus","volume":"52","author":"Bultink","year":"2005","journal-title":"Arthritis Rheum."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1055\/s-0036-1592371","article-title":"Radiology of Osteoporosis: Old and New Findings","volume":"20","author":"Fan","year":"2016","journal-title":"Semin. Musculoskelet. Radiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1055\/s-0036-1592435","article-title":"Vertebral Fracture Identification","volume":"20","author":"Bazzocchi","year":"2016","journal-title":"Semin. Musculoskelet. Radiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"587","DOI":"10.2214\/ajr.140.3.587","article-title":"Radiologic findings in late-onset systemic lupus erythematosus","volume":"140","author":"Braunstein","year":"1983","journal-title":"Am. J. Roentgenol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/s12969-019-0372-z","article-title":"Juvenile systemic lupus erythematosus presenting as pancarditis","volume":"17","author":"Nertney","year":"2019","journal-title":"Pediatr. Rheumatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1177\/0961203307087875","article-title":"Adolescent onset of lupus results in more aggressive disease and worse outcomes: Results of a nested matched case\u2013control study within LUMINA, a multiethnic US cohort (LUMINA LVII)","volume":"17","author":"Tucker","year":"2008","journal-title":"Lupus"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.pcl.2012.03.007","article-title":"Systemic Lupus Erythematosus in Children and Adolescents","volume":"59","author":"Levy","year":"2012","journal-title":"Pediatr. Clin. N. Am."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1002\/art.24090","article-title":"Musculoskeletal sonography in juvenile systemic lupus erythematosus","volume":"61","author":"Demirkaya","year":"2009","journal-title":"Arthritis Care Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s12969-015-0008-x","article-title":"Avascular necrosis in pediatric systemic lupus erythematosus: A brief report and review of the literature","volume":"13","author":"Gurion","year":"2015","journal-title":"Pediatr. Rheumatol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1177\/0961203319869467","article-title":"Risk factors for bone loss in juvenile-onset systemic lupus erythematosus: A prospective study","volume":"28","author":"Paupitz","year":"2019","journal-title":"Lupus"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1055\/s-0036-1592369","article-title":"Bone Densitometry in Children","volume":"20","author":"Adams","year":"2016","journal-title":"Semin. Musculoskelet. Radiol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/17\/5212\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:22:49Z","timestamp":1760142169000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/17\/5212"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,3]]},"references-count":33,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["jcm11175212"],"URL":"https:\/\/doi.org\/10.3390\/jcm11175212","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,3]]}}}