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High-resolution musculoskeletal ultrasonography and elastography for eosinophilic fasciitis diagnosis and follow-up: a case-based review

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Abstract

Eosinophilic fasciitis (EF) remains a rare condition without precise diagnostic criteria due to common symptoms with other autoimmune diseases requiring broad differential diagnosis. This paper describes the use of high-resolution musculoskeletal ultrasonography and elastography in the diagnosis and follow-up of eosinophilic fasciitis through the case of a 56-year-old male patient. In addition to laboratory data, instrumental data, and biopsy, musculoskeletal ultrasonography (US) was used both in the diagnostic process and in the follow-up period for an objective assessment of the changes in the patient’s condition and response to treatment. The US showed disorganization of the myofibrils adjacent to the superficial fascia, edema, and thickening of the fascia and subcutaneous edema. In addition, the use of shear-wave elastography (SWE) demonstrated significantly reduced skin elasticity. High-frequency musculoskeletal ultrasound in combination with SWE is an effective method both for the diagnosis of EF and for the follow-up of the changes occurring after therapy. Based on the fact that it can easily differentiate the substrate of involvement, such as skin, subcutaneous tissue, or muscle fascia, ultrasound can be used to distinguish EF from other skin and muscle diseases.

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Data availability

The data is available on reasonable request from the corresponding author.

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Authors and Affiliations

  1. Department of Rheumatology, Medical University of Plovdiv, Plovdiv, Bulgaria

    Velichka Popova, Zguro Batalov, Rositsa Karalilova & Anastas Batalov

  2. Department of Propaedeutics of Internal Diseases, Medical University of Plovdiv, Plovdiv, Bulgaria

    Aleksandar Botushanov

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  1. Velichka Popova
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  2. Aleksandar Botushanov
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  3. Zguro Batalov
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  4. Rositsa Karalilova
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  5. Anastas Batalov
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Contributions

The authors confirm contribution to the paper as follows: case-based review conception and design: VP, AB; data collection: VP, ZB; analysis and interpretation of results: VP, AB, ZB, RK, AB; ultrasound and elastography: AB, AB, RK; capillaroscopy: RK; draft manuscript preparation: VP, AB, ZB, RK, AB article revision: VP, AB, AB. All authors reviewed the results and approved the final version of the manuscript.

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Correspondence to Velichka Popova.

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All procedures performed in the study were in compliance with the World Medical Association Declaration of Helsinki (1964) and its revised version (Edinburgh, 2000). Informed consent in written form was obtained from the patient regarding all laboratory tests, instrumental examinations, imaging studies, and biopsy, as well as for the use of the data in scientific publications.

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Popova, V., Botushanov, A., Batalov, Z. et al. High-resolution musculoskeletal ultrasonography and elastography for eosinophilic fasciitis diagnosis and follow-up: a case-based review. Rheumatol Int 43, 2311–2318 (2023). https://doi.org/10.1007/s00296-023-05401-7

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  • DOI: https://doi.org/10.1007/s00296-023-05401-7

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