Usefulness of sonography in the diagnosis of rheumatoid hand
Ultrasound examination is becoming more and more common in patients with rheumatoid diseases. Above all, it enables the assessment of articular soft tissues and constitutes a non-invasive examination. In a rheumatologist’s everyday practice, it is conducted at the stage of initial diagnosis as we...
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| Format: | Article |
| Language: | English |
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Sciendo
2013-09-01
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| Series: | Journal of Ultrasonography |
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| Online Access: | http://jultrason.pl/index.php/issues/volume-13-no-54/usefulness-of-sonography-in-the-diagnosis-of-rheumatoid-hand?aid=174 |
| _version_ | 1828520456287682560 |
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| author | Katarzyna Zaniewicz‑Kaniewska Iwona Sudoł‑Szopińska |
| author_facet | Katarzyna Zaniewicz‑Kaniewska Iwona Sudoł‑Szopińska |
| author_sort | Katarzyna Zaniewicz‑Kaniewska |
| collection | DOAJ |
| description | Ultrasound examination is becoming more and more common in patients with rheumatoid
diseases. Above all, it enables the assessment of articular soft tissues and constitutes
a non-invasive examination. In a rheumatologist’s everyday practice, it is conducted at
the stage of initial diagnosis as well as to monitor the treatment and to confirm the remission
if the clinical picture is ambiguous. The first sign of arthritis (including rheumatoid
arthritis) that is visible on ultrasound examination is the thickening of the synovial membrane
of the joint cavities, tendon sheaths or bursae. It is frequently accompanied by
the exudate in the joint, sheath or bursa. In a subsequent stage, in Doppler examination,
enhanced vascularization of the synovial membrane is observed. Sometimes, the inflammatory
process of the tendon sheaths also affects the tendons, which might lead to their
damage. Moreover, ultrasound examination also reveals erosions and inflammatory cysts
(geodes) which attest to the advancement of the disease. A dynamic ultrasound examination
enables to diagnose the capsule-ligamentous contracture of the interphalangeal
joints, which occurs due to the lack of rehabilitation that should begin at the moment of
the commencement of the inflammation. The ultrasound image does not allow for the differentiation
between various rheumatoid entities, including those encompassing the joints
in the hand, wrist. The observed changes, i.e. thickening of the synovial membrane,
hyperemia, effusions, erosions or tendon damage, may accompany various rheumatoid
entities. The purpose of the ultrasound examination is to recognize these irregularities,
determine their localization and advancement and, finally, to monitor the course of treatment.
Furthermore, ultrasound scan enables to assess the joints and tendons in a dynamic
examination in relation to local ailments of the patient as well as to monitor the biopsy,
aspiration and medicine administration. Sonography is used for a US-guided administration
of radioisotope substances for synoviorthesis. |
| first_indexed | 2024-12-11T19:31:16Z |
| format | Article |
| id | doaj.art-d395a75c31804d16aa5b601feb373287 |
| institution | Directory Open Access Journal |
| issn | 2084-8404 2451-070X |
| language | English |
| last_indexed | 2024-12-11T19:31:16Z |
| publishDate | 2013-09-01 |
| publisher | Sciendo |
| record_format | Article |
| series | Journal of Ultrasonography |
| spelling | doaj.art-d395a75c31804d16aa5b601feb3732872022-12-22T00:53:16ZengSciendoJournal of Ultrasonography2084-84042451-070X2013-09-011354329336Usefulness of sonography in the diagnosis of rheumatoid handKatarzyna Zaniewicz‑Kaniewska0Iwona Sudoł‑Szopińska1Zakład Radiologii, Instytut Reumatologii, Warszawa, PolskaZakład Radiologii, Instytut Reumatologii, Warszawa, Polska; Zakład Diagnostyki Obrazowej, II Wydział Lekarski, Warszawski Uniwersytet Medyczny, Warszawa, PolskaUltrasound examination is becoming more and more common in patients with rheumatoid diseases. Above all, it enables the assessment of articular soft tissues and constitutes a non-invasive examination. In a rheumatologist’s everyday practice, it is conducted at the stage of initial diagnosis as well as to monitor the treatment and to confirm the remission if the clinical picture is ambiguous. The first sign of arthritis (including rheumatoid arthritis) that is visible on ultrasound examination is the thickening of the synovial membrane of the joint cavities, tendon sheaths or bursae. It is frequently accompanied by the exudate in the joint, sheath or bursa. In a subsequent stage, in Doppler examination, enhanced vascularization of the synovial membrane is observed. Sometimes, the inflammatory process of the tendon sheaths also affects the tendons, which might lead to their damage. Moreover, ultrasound examination also reveals erosions and inflammatory cysts (geodes) which attest to the advancement of the disease. A dynamic ultrasound examination enables to diagnose the capsule-ligamentous contracture of the interphalangeal joints, which occurs due to the lack of rehabilitation that should begin at the moment of the commencement of the inflammation. The ultrasound image does not allow for the differentiation between various rheumatoid entities, including those encompassing the joints in the hand, wrist. The observed changes, i.e. thickening of the synovial membrane, hyperemia, effusions, erosions or tendon damage, may accompany various rheumatoid entities. The purpose of the ultrasound examination is to recognize these irregularities, determine their localization and advancement and, finally, to monitor the course of treatment. Furthermore, ultrasound scan enables to assess the joints and tendons in a dynamic examination in relation to local ailments of the patient as well as to monitor the biopsy, aspiration and medicine administration. Sonography is used for a US-guided administration of radioisotope substances for synoviorthesis.http://jultrason.pl/index.php/issues/volume-13-no-54/usefulness-of-sonography-in-the-diagnosis-of-rheumatoid-hand?aid=174rheumatoid arthritisrheumatoid handsonographysynovitistenosynovitisbursitis |
| spellingShingle | Katarzyna Zaniewicz‑Kaniewska Iwona Sudoł‑Szopińska Usefulness of sonography in the diagnosis of rheumatoid hand Journal of Ultrasonography rheumatoid arthritis rheumatoid hand sonography synovitis tenosynovitis bursitis |
| title | Usefulness of sonography in the diagnosis of rheumatoid hand |
| title_full | Usefulness of sonography in the diagnosis of rheumatoid hand |
| title_fullStr | Usefulness of sonography in the diagnosis of rheumatoid hand |
| title_full_unstemmed | Usefulness of sonography in the diagnosis of rheumatoid hand |
| title_short | Usefulness of sonography in the diagnosis of rheumatoid hand |
| title_sort | usefulness of sonography in the diagnosis of rheumatoid hand |
| topic | rheumatoid arthritis rheumatoid hand sonography synovitis tenosynovitis bursitis |
| url | http://jultrason.pl/index.php/issues/volume-13-no-54/usefulness-of-sonography-in-the-diagnosis-of-rheumatoid-hand?aid=174 |
| work_keys_str_mv | AT katarzynazaniewiczkaniewska usefulnessofsonographyinthediagnosisofrheumatoidhand AT iwonasudołszopinska usefulnessofsonographyinthediagnosisofrheumatoidhand |