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image of Systemic Sclerosis Complicated by Rapidly Progressive Osteomyelitis: A Case Report

Abstract

Background

Systemic sclerosis (SSc) is an autoimmune disorder characterized by progressive fibrosis and vascular complications. Osteomyelitis is a rare but serious complication in patients with systemic sclerosis, particularly those with advanced vascular compromise. This case is notable for the rapid progression of osteomyelitis and highlights the importance of early intervention and thorough clinical monitoring.

Case Presentation

We report the case of a 68-year-old female with SSc (Scl-70 positive), treated with iloprost IV, nifedipine, bosentan, prednisone, and mycophenolate for pulmonary involvement. In January 2024, she developed acrocyanosis and severe pain in the fifth toe of the right foot. A small ulcer formed, and subsequent radiographic evaluation revealed rapid progression of osteolysis. Despite negative culture swabs, an infectious process was suspected, and combination antibiotic therapy was initiated. This treatment led to a gradual resolution of symptoms, with subsequent imaging showing detachment of the fifth toe.

Conclusion

This case highlights the critical need for vigilant radiographic monitoring and timely antibiotic intervention in patients with SSc who develop vascular complications. Early diagnosis and treatment are crucial for optimizing patient outcomes and preventing severe bone damage.

© 2025 Bentham Science Publishers
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2025-02-06
2025-05-07

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References

  1. Denton C.P. Khanna D. Systemic sclerosis. Lancet 2017 390 10103 1685 1699 10.1016/S0140‑6736(17)30933‑9 28413064
    [Google Scholar]
  2. Bellando Randone S Guiducci S Matucci Cerinic M. Musculoskeletal involvement in systemic sclerosis. Best Pract. Res. Clin. Rheumatol. 2008 22 2 339 350
    [Google Scholar]
  3. González J.M. Valenzuela A. Vascular, soft tissue, and musculoskeletal imaging in systemic sclerosis. Rheum. Dis. Clin. North Am. 2024 50 4 661 681 10.1016/j.rdc.2024.07.006 39415373
    [Google Scholar]
  4. Cutolo M Sulli A Smith V Assessing microvascular changes in systemic sclerosis diagnosis and management. Nat. Rev. Rheumatol. 2010 6 10 578 587 10.1038/nrrheum.2010.104
    [Google Scholar]
  5. Singh J.A. Cleveland J.D. Serious infections in people with systemic sclerosis: A national US study. Arthritis Res. Ther. 2020 22 1 163 10.1186/s13075‑020‑02216‑w 32600412
    [Google Scholar]
  6. Thietart S. Louati K. Gatfosse M. Sornay-Rendu E. Gaigneux E. Lemeunier L. Delmaire P. Riviere S. Mahevas T. Sellam J. Berenbaum F. Fain O. Roland C. Mekinian A. Overview of osteo-articular involvement in systemic sclerosis: Specific risk factors, clinico-sonographic evaluation, and comparison with healthy women from the French OFELY cohort. Best Pract. Res. Clin. Rheumatol. 2018 32 4 591 604 10.1016/j.berh.2019.01.008 31174827
    [Google Scholar]
  7. Lovell C.R. Jayson M.I.V. Joint involvement in systemic sclerosis. Scand. J. Rheumatol. 1979 8 3 154 160 10.3109/03009747909114448 493891
    [Google Scholar]
  8. Yayla M.E. Yurteri̇ E.U. Torğutalp M. Eroğlu D.Ş. Sezer S. Di̇nçer A.B.K. Gülöksüz e.g. A. Yüksel M.L. Yilmaz R. Ateş A. Turğay T.M. Kinikli G. Causes of severe infections in patients with systemic sclerosis and associated factors. Turk. J. Med. Sci. 2022 52 6 1881 1888 10.55730/1300‑0144.5535 36945989
    [Google Scholar]
  9. Gumkowska-Sroka O. Kotyla K. Mojs E. Palka K. Kotyla P. Novel therapeutic strategies in the treatment of systemic sclerosis. Pharmaceuticals 2023 16 8 1066 10.3390/ph16081066 37630981
    [Google Scholar]
  10. Walker K.M. Pope J. Treatment of systemic sclerosis complications: What to use when first-line treatment fails--A consensus of systemic sclerosis experts. Semin. Arthritis Rheum. 2012 42 1 42 55 10.1016/j.semarthrit.2012.01.003 22464314
    [Google Scholar]
  11. van den Hoogen F. Khanna D. Fransen J. Johnson S.R. Baron M. Tyndall A. Matucci-Cerinic M. Naden R.P. Medsger T.A. Jr Carreira P.E. Riemekasten G. Clements P.J. Denton C.P. Distler O. Allanore Y. Furst D.E. Gabrielli A. Mayes M.D. van Laar J.M. Seibold J.R. Czirjak L. Steen V.D. Inanc M. Kowal-Bielecka O. Müller-Ladner U. Valentini G. Veale D.J. Vonk M.C. Walker U.A. Chung L. Collier D.H. Csuka M.E. Fessler B.J. Guiducci S. Herrick A. Hsu V.M. Jimenez S. Kahaleh B. Merkel P.A. Sierakowski S. Silver R.M. Simms R.W. Varga J. Pope J.E. 2013 classification criteria for systemic sclerosis: An American College of Rheumatology/European League against Rheumatism collaborative initiative. Arthritis Rheum. 2013 65 11 2737 2747 10.1002/art.38098 24122180
    [Google Scholar]
  12. Matucci-Cerinic M. Allanore Y. Czirják L. Tyndall A. Müller-Ladner U. Denton C. Valentini G. Distler O. Fligelstone K. Tyrrel-Kennedy A. Farge D. Kowal-Bielecka O. van den Hoogen F. Cutolo M. Sampaio-Barros P.D. Nash P. Takehara K. Furst D.E. The challenge of early systemic sclerosis for the EULAR Scleroderma Trial and Research group (EUSTAR) community. It is time to cut the Gordian knot and develop a prevention or rescue strategy. Ann. Rheum. Dis. 2009 68 9 1377 1380 10.1136/ard.2008.106302 19674983
    [Google Scholar]
  13. Bertolino J. Jouve E. Skopinski S. Agard C. Achille A. Thoreau B. Diot E. Sanges S. Berthier S. Chaigne B. Régent A. Martin T. Pugnet G. Benyamine A. Rossi P. Launay D. Mouthon L. Granel B. Characteristics of patients with systemic sclerosis suffering from a lower limb amputation: Results of a French collaborative study. J. Scleroderma Relat. Disord. 2020 5 3 224 230 10.1177/2397198320913689 35382523
    [Google Scholar]
  14. Pătrîntașu D.E. Sárközi H.K. Lupușor E. Vlangăr i.e. Rotariu G.M. Rența I.A. Nan A.N. Budin C.E. A multidisciplinary approach as a goal for the management of complications in systemic scleroderma: A literature review and case scenario. Diagnostics 2023 13 21 3332 10.3390/diagnostics13213332 37958228
    [Google Scholar]
  15. Lepri G. Di Battista M. Codullo V. Bonomi F. Sulis A. Guiducci S. Della Rossa A. Systemic sclerosis: One year in review 2024. Clin. Exp. Rheumatol. 2024 42 8 1517 1528 10.55563/clinexprheumatol/is29he 39058484
    [Google Scholar]
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Systemic Sclerosis Complicated by Rapidly Progressive Osteomyelitis: A Case Report
Bentham Science Publishers ; https://doi.org/10.2174/0115733971365099250205151000
/content/journals/crr/10.2174/0115733971365099250205151000
/content/journals/crr/10.2174/0115733971365099250205151000
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  • Article Type:     Case Report
Keywords: acrocyanosis ; Systemic sclerosis ; radiographic monitoring ; antibiotic therapy ; osteomyelitis

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