Radiographs were reviewed of the chest, hands, and feet of 55 patients with progressive systemic sclerosis. These patients had been selected so as to exclude overlap syndromes, particularly mixed connective tissue disease. Soft tissue changes included flexion deformities, generalized or localized atrophy, and dystrophic calcifications. While resorption of distal phalanges was the most common bony change, osteolysis in other sites (feet, ribs, and mandibles) was also frequent. Twelve of 55 patients showed radiographic evidence of inflammatory arthritis, ranging from isolated to generalized joint destruction, that could not be attributed to overlap with rheumatoid arthritis or mixed connective tissue disease.