Flower VA, Barratt SL, Hart DJ, et al. - In this study, the association between high-frequency ultrasound (HFUS) with both modified Rodnan skin score (mRSS) and dermal collagen was explored. Researchers evaluated skin thickness (ST), echogenicity, and novel shear wave elastography (SWE) in 53 patients with SSc and 15 healthy controls (HCs) at the finger, hand, forearm, and abdomen. They tested association between HFUS parameters with mRSS (n = 53) and dermal collagen (10 patients with SSc and 10 HCs). Intraclass correlation coefficients were used to calculate intraobserver repeatability of HFUS. The result reveals excellent reproducibility and reassuring convergent validity with dermal collagen content. The data demonstrate that detection of subclinical abnormalities is an additional benefit of HFUS. The observed association with collagen quantification supports future evaluation of HFUS as an alternative to mRSS in clinical trial settings.