Similar bone manifestations of scleroderma and rheumatoid arthritis

The hands and wrists of 24 patients with scleroderma were reviewed. Although, in the majority of cases, the phalangeal alterations of scleroderma were quite typical, many features similar to those encountered in rheumatoid arthritis were noted; e.g., bone erosions, narrowing of the joints, alteration of the ulnar styloid process, subluxations, and even ankylosis of the wrist. Many of these overlapping features were originally considered pathognomonic for rheumatoid arthritis. The presence of synovitis in scleroderma, similar to that encountered in early rheumatoid arthritis, probably accounts for many of these manifestations.