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Original Research |

The Nature of Joint Involvement in Progressive Systemic Sclerosis (Diffuse Scleroderma): Clinical Study and Pathologic Examination of Synovium in Twenty-nine Patients

Ann Intern Med. 1962;56(3):422-439. doi:10.7326/0003-4819-56-3-422
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Involvement of the joints in progressive systemic sclerosis was first noted in 1847 by Forget who described a 33-year-old woman whose initial symptoms were pain and swelling of many joints and whose "wrists still bore the traces of leeches and of cupping glasses" (1). The great frequency of these and other joint complaints at the onset or during the course of scleroderma was soon recognized and interpreted variously as indicative of rheumatism or simply related to change in the overlying skin. In 1896 Dercum secured roentgenograms of the hands of a patient with scleroderma and noted narrowing of the proximal


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