Ultrasonographic assessment of digital ulcers in systemic sclerosis: Quantitative and qualitative insights for evaluation and follow-up

Objective: The objective of this study is to examine the efficacy of ultrasonography in evaluating and tracking the healing process of digital ulcers in patients with systemic sclerosis.Methods: The study cohort comprised 23 patients with systemic sclerosis and digital ulcers. Gray Scale and Power Doppler ultrasonography was employed for the assessment of lesions. Subsequently, a sharp debridement was administered, followed by the application of hydrocolloid dressings. The healing process was then monitored through follow-up and using ultrasonography.Results: Of the 46 ulcers observed, 34 demonstrated complete healing, while 12 did not. The use of Power Doppler ultrasonography was found to be a highly significant indicator of healing. Significant statistical differences were observed in lesion dimensions (length, width, depth) between the healed and non-healed groups and a strong correlation was observed between the reduction in lesion dimensions and the healing process. The results of the point-biserial correlation analysis indicated a robust positive correlation between healing and alterations in length (r = 0.600) and width (r = 0.576), and a moderate positive correlation with depth (r = 0.400).Conclusion: The findings of this study indicate that the ultrasonography is a feasible and objective method to assess digital ulcers and their healing. Reduction of length and width and presence of Power Doppler ultrasonography are strong indicators of wound repair. Furthermore, the presence of necrotic tissue is not an indicator for a poor outcome. Ultrasonography offers comprehensive qualitative and quantitative data that facilitate a deeper comprehension and monitoring of the healing process.