Advertisement

Sonopathology: Pathological Findings (Articular and Periarticular)

  • Emilio Filippucci
  • Peter Mandl
  • Peter Vince Balint
  • Walter Grassi
Chapter

Abstract

A pictorial and literature review of the most relevant pathological findings detected by ultrasound in the hand and the wrist, including synovial hyperplasia and fluid, tendon tears, enthesitis, cartilage and bone abnormalities, crystal deposits, and vascular changes associated with connective tissue diseases.

Keywords

Synovitis Enthesitis Tenosynovitis Cartilage damage Bone erosion 

References

  1. 1.
    Mandl P, Naredo E, Wakefield RJ, Conaghan PG, D’Agostino MA, OMERACT Ultrasound Task Force. A systematic literature review analysis of ultrasound joint count and scoring systems to assess synovitis in rheumatoid arthritis according to the OMERACT filter. J Rheumatol. 2011;38:2055–62.CrossRefPubMedGoogle Scholar
  2. 2.
    Filer A, de Pablo P, Allen G, Nightingale P, Jordan A, Jobanputra P, Bowman S, Buckley CD, Raza K. Utility of ultrasound joint counts in the prediction of rheumatoid arthritis in patients with very early synovitis. Ann Rheum Dis. 2011;70:500–7.CrossRefPubMedGoogle Scholar
  3. 3.
    Scheel AK, Hermann KG, Kahler E, Pasewaldt D, Fritz J, Hamm B, Brunner E, Müller GA, Burmester GR, Backhaus M. A novel ultrasonographic synovitis scoring system suitable for analyzing finger joint inflammation in rheumatoid arthritis. Arthritis Rheum. 2005;52:733–43.CrossRefPubMedGoogle Scholar
  4. 4.
    Hau M, Schultz H, Tony HP, Keberle M, Jahns R, Haerten R, Jenett M. Evaluation of pannus and vascularization of the metacarpophalangeal and proximal interphalangeal joints in rheumatoid arthritis by high-resolution ultrasound (multidimensional linear array). Arthritis Rheum. 1999;42:2303–8.CrossRefGoogle Scholar
  5. 5.
    De Flaviis L, Scaglione P, Nessi R, Ventura R, Calori G. Ultrasonography of the hand in rheumatoid arthritis. Acta Radiol. 1988;29:457–60.CrossRefPubMedGoogle Scholar
  6. 6.
    Witt MN, Mueller F, Weinert P, Nigg AP, Reindl CS, Proft F, Schulze-Koops H, Grunke M. Ultrasound of synovitis in rheumatoid arthritis: advantages of the dorsal over the palmar approach to finger joints. J Rheumatol. 2014;41:422–8.CrossRefPubMedGoogle Scholar
  7. 7.
    Cardinal E, Lafortune M, Burns P. Power Doppler US in synovitis: reality or artifact? Radiology. 1996;200:868–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Klauser A, Frauscher F, Schirmer M, Halpern E, Pallwein L, Herold M, Helweg G, ZurNedden D. The value of contrast-enhanced color Doppler ultrasound in the detection of vascularization of finger joints in patients with rheumatoid arthritis. Arthritis Rheum. 2002;46:647–53.CrossRefGoogle Scholar
  9. 9.
    Terslev L, Torp-Pedersen S, Qvistgaard E, von der Recke P, Bliddal H. Doppler ultrasound findings in healthy wrists and finger joints. Ann Rheum Dis. 2004;63:644–8.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Albrecht K, Grob K, Lange U, Müller-Ladner U, Strunk J. Reliability of different Doppler ultrasound quantification methods and devices in the assessment of therapeutic response in arthritis. Rheumatology. 2008;47:1521–6.CrossRefPubMedGoogle Scholar
  11. 11.
    Torp-Pedersen S, Christensen R, Szkudlarek M, Ellegaard K, D’Agostino MA, Iagnocco A, Naredo E, Balint P, Wakefield RJ, Torp-Pedersen A, Terslev L. Power and color Doppler ultrasound settings for inflammatory flow: impact on scoring of disease activity in patients with rheumatoid arthritis. Arthritis Rheumatol. 2015;67:386–95.CrossRefPubMedGoogle Scholar
  12. 12.
    Rezaei H, Af Klint E, Hammer HB, Terslev L, D’Agostino MA, Kisten Y, Arnaud L. Analysis of correlation and causes for discrepancy between quantitative and semi-quantitative Doppler scores in synovitis in rheumatoid arthritis. Rheumatology. 2017;56:255–62.CrossRefPubMedGoogle Scholar
  13. 13.
    Wakefield RJ, Balint PV, Szkudlarek M, Filippucci E, Backhaus M, D’Agostino MA, Sanchez EN, Iagnocco A, Schmidt WA, Bruyn GA, Kane D, O’Connor PJ, Manger B, Joshua F, Koski J, Grassi W, Lassere MN, Swen N, Kainberger F, Klauser A, Ostergaard M, Brown AK, Machold KP, Conaghan PG; OMERACT 7 Special Interest Group. Musculoskeletal ultrasound including definitions for ultrasonographic pathology. J Rheumatol. 2005;32:2485–7.Google Scholar
  14. 14.
    Filippucci E, Gabba A, Di Geso L, Girolimetti R, Salaffi F, Grass W. Hand tendon involvement in rheumatoid arthritis: an ultrasound study. Semin Arthritis Rheum. 2012;41:752–60.CrossRefPubMedGoogle Scholar
  15. 15.
    Østergaard M, Eder L, Christiansen SN, Kaeley GS. Imaging in the diagnosis and management of peripheral psoriatic arthritis-the clinical utility of magnetic resonance imaging and ultrasonography. Best Pract Res Clin Rheumatol. 2016;30:624–37.CrossRefPubMedGoogle Scholar
  16. 16.
    Kim HR, Lee SH. Ultrasonographic assessment of clinically diagnosed trigger fingers. Rheumatol Int. 2010;30:1455–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Guerini H, Pessis E, Theumann N, Le Quintrec JS, Campagna R, Chevrot A, Feydy A, Drapé JL. Sonographic appearance of trigger fingers. J Ultrasound Med. 2008;27:1407–13.CrossRefPubMedGoogle Scholar
  18. 18.
    Bakewell CJ, Olivieri I, Aydin SZ, Dejaco C, Ikeda K, Gutierrez M, Terslev L, Thiele R, D’Agostino MA, Kaeley GS, OMERACT Ultrasound Task Force. Ultrasound and magnetic resonance imaging in the evaluation of psoriatic dactylitis: status and perspectives. J Rheumatol. 2013;40:1951–7.CrossRefPubMedGoogle Scholar
  19. 19.
    McGonagle D, Gibbon W, O’Connor P, Green M, Pease C, Emery P. Characteristic magnetic resonance imaging entheseal changes of knee synovitis in spondylarthropathy. Arthritis Rheum. 1998;41:694–700.CrossRefPubMedGoogle Scholar
  20. 20.
    McGonagle D, Gibbon W, Emery P. Classification of inflammatory arthritis by enthesitis. Lancet. 1998;352:1137–40.CrossRefPubMedGoogle Scholar
  21. 21.
    McGonagle D, Pease C, Marzo-Ortega H, O’Connor P, Emery P. The case for classification of polymyalgia rheumatica and remitting seronegative symmetrical synovitis with pitting edema as primarily capsular/entheseal based pathologies. J Rheumatol. 2000;27:837–40.PubMedGoogle Scholar
  22. 22.
    Tan AL, Benjamin M, Toumi H, Grainger AJ, Tanner SF, Emery P, McGonagle D. The relationship between the extensor tendon enthesis and the nail in distal interphalangeal joint disease in psoriatic arthritis–a high-resolution MRI and histological study. Rheumatology. 2007;46:253–6.CrossRefPubMedGoogle Scholar
  23. 23.
    McGonagle D, Tan AL, Benjamin M. The nail as a musculoskeletal appendage-implications for an improved understanding of the link between psoriasis and arthritis. Dermatology. 2009;218:97–102.CrossRefPubMedGoogle Scholar
  24. 24.
    Filippucci E, da Luz KR, Di Geso L, Salaffi F, Tardella M, Carotti M, Natour J, Grassi W. Interobserver reliability of ultrasonography in the assessment of cartilage damage in rheumatoid arthritis. Ann Rheum Dis. 2010;69:1845–8.CrossRefPubMedGoogle Scholar
  25. 25.
    Mandl P, Supp G, Baksa G, Radner H, Studenic P, Gyebnar J, Kurucz R, Niedermayer D, Aletaha D, Balint PV, Smolen JS. Relationship between radiographic joint space narrowing, sonographic cartilage thickness and anatomy in rheumatoid arthritis and control joints. Ann Rheum Dis. 2015;74:2022–7.CrossRefPubMedGoogle Scholar
  26. 26.
    Filippucci E, Meenagh G, Delle Sedie A, Salaffi F, Riente L, Iagnocco A, Scirè CA, Montecucco C, Bombardieri S, Valesini G, Grassi W. Ultrasound imaging for the rheumatologist. XX. Sonographic assessment of hand and wrist joint involvement in rheumatoid arthritis: comparison between two- and three-dimensional ultrasonography. Clin Exp Rheumatol. 2009;27:197–200.PubMedGoogle Scholar
  27. 27.
    Tămaş MM, Filippucci E, Becciolini A, Gutierrez M, Di Geso L, Bonfiglioli K, Voulgari PV, Salaffi F, Grassi W. Bone erosions in rheumatoid arthritis: ultrasound findings in the early stage of the disease. Rheumatology. 2014;53:1100–7.CrossRefPubMedGoogle Scholar
  28. 28.
    Grassi W, Filippucci E, Farina A, Salaffi F, Cervini C. Ultrasonography in the evaluation of bone erosions. Ann Rheum Dis. 2001;60:98–103.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Tan AL, Tanner SF, Conaghan PG, Radjenovic A, O’Connor P, Brown AK, Emery P, McGonagle D. Role of metacarpophalangeal joint anatomic factors in the distribution of synovitis and bone erosion in early rheumatoid arthritis. Arthritis Rheum. 2003;48:1214–22.CrossRefPubMedGoogle Scholar
  30. 30.
    Chowalloor PV, Siew TK, Keen HI. Imaging in gout: a review of the recent developments. Ther Adv Musculoskelet Dis. 2014;6:131–43.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Wright SA, Filippucci E, McVeigh C, Grey A, McCarron M, Grassi W, Wright GD, Taggart AJ. High-resolution ultrasonography of the first metatarsal phalangeal joint in gout: a controlled study. Ann Rheum Dis. 2007;66:859–64.CrossRefPubMedGoogle Scholar
  32. 32.
    Zayat AS, Ellegaard K, Conaghan PG, Terslev L, Hensor EM, Freeston JE, Emery P, Wakefield RJ. The specificity of ultrasound-detected bone erosions for rheumatoid arthritis. Ann Rheum Dis. 2015;74:897–903.CrossRefPubMedGoogle Scholar
  33. 33.
    Martel W, Stuck KJ, Dworin AM, Hylland RG. Erosive osteoarthritis and psoriatic arthritis: a radiologic comparison in the hand, wrist, and foot. Am J Roentgenol. 1980;134:125–35.CrossRefGoogle Scholar
  34. 34.
    Keen HI, Lavie F, Wakefield RJ, D’Agostino MA, Berner-Hammer H, Hensor EMA, Pendleton A, Kane D, Guerini H, Schueller-Weidekamm C, Kortekaas MC, Birrel F, Kloppenburg M, Stamm T, Watt I, Smolen JS, Maheu E, Dougados M, Conaghan PG. The development of a preliminary ultrasonographic scoring system for features of hand osteoarthritis. Ann Rheum Dis. 2008;67:651–5.CrossRefPubMedGoogle Scholar
  35. 35.
    Hammer HB, Iagnocco A, Mathiessen A, Filippucci E, Gandjbakhch F, Kortekaas MC, Möller I, Naredo E, Wakefield RJ, Aegerter P, D’Agostino MA. Global ultrasound assessment of structural lesions in osteoarthritis: a reliability study by the OMERACT ultrasonography group on scoring cartilage and osteophytes in finger joints. Ann Rheum Dis. 2016;75:402–7.CrossRefPubMedGoogle Scholar
  36. 36.
    Filippucci E, Di Geso L, Girolimetti R, Grassi W. Ultrasound in crystal-related arthritis. Clin Exp Rheumatol. 2014;32:S42–7.PubMedGoogle Scholar
  37. 37.
    Irsay L, Mandl P, Balint PV. Chapter 3: pitfalls of gray-scale artifacts. In: D’Agostino MA, Wakefield RJ, editors. Essential applications of ultrasound in rheumatology. Philadelphia: Elsevier; 2010. p. 29–43.CrossRefGoogle Scholar
  38. 38.
    Frediani B, Filippou G, Falsetti P, Lorenzini S, Baldi F, Acciai C, Siagkri C, Marotto D, Galeazzi M, Marcolongo R. Diagnosis of calcium pyrophosphate dihydrate crystal deposition disease: ultrasonographic criteria proposed. Ann Rheum Dis. 2005;64:638–40.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Carmona L, González-Alvaro I, Balsa A, Angel Belmonte M, Tena X, Sanmartí R. Rheumatoid arthritis in Spain: occurrence of extra-articular manifestations and estimates of disease severity. Ann Rheum Dis. 2003;62:897–900.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    McDonagh C, Alexander M, Kane D. The role of ultrasound in the diagnosis and management of carpal tunnel syndrome: a new paradigm. Rheumatology. 2015;54:9–19.CrossRefPubMedGoogle Scholar
  41. 41.
    Buchberger W, Schon G, Strasser K, Jungwirth W. High-resolution ultrasonography of the carpal tunnel. J Ultrasound Med. 1991;10:531–7.CrossRefPubMedGoogle Scholar
  42. 42.
    Martinoli C, Bianchi S, Gandolfo N, Valle M, Simonetti S, Derchi LE. US of nerve entrapments in osteofibrous tunnels of the upper and lower limbs. Radiographics. 2000;20:S199–213.CrossRefPubMedGoogle Scholar
  43. 43.
    Kamolz LP, Schrögendorfer KF, Rab M, Girsch W, Gruber H, Frey M. The precision of ultrasound imaging and its relevance for carpal tunnel syndrome. Surg Radiol Anat. 2001;23:117–21.CrossRefPubMedGoogle Scholar
  44. 44.
    Zayat AS, Md Yusof MY, Wakefield RJ, Conaghan PG, Emery P, Vital EM. The role of ultrasound in assessing musculoskeletal symptoms of systemic lupus erythematosus: a systematic literature review. Rheumatology. 2016;55:485–94.PubMedGoogle Scholar
  45. 45.
    Saketkoo LA, Quinet R. Revisiting Jaccoud arthropathy as an ultrasound diagnosed erosive arthropathy in systemic lupus erythematosus. J Clin Rheumatol. 2007;13:322–7.CrossRefPubMedGoogle Scholar
  46. 46.
    Bianchi S, Abdelwahab IF, Zwass A, Giacomello P. Ultrasonographic evaluation of wrist ganglia. Skelet Radiol. 1994;23:201–3.CrossRefGoogle Scholar
  47. 47.
    Ebrahim FS, De Maeseneer M, Jager T, Marcelis S, Jamadar DA, Jacobson JA. US diagnosis of UCL tears of the thumb and Stener lesions: technique, pattern-based approach, and differential diagnosis. Radiographics. 2006;26:1007–20.CrossRefPubMedGoogle Scholar
  48. 48.
    Markham DE, Wood MR. Ultrasound for Dupuytren’s contracture. Physiotherapy. 1980;66:55–8.PubMedGoogle Scholar
  49. 49.
    Teh J, Vlychou M. Ultrasound-guided interventional procedures of the wrist and hand. Eur Radiol. 2009;19:1002–10.CrossRefPubMedGoogle Scholar
  50. 50.
    Colio SW, Smith J, Pourcho AM. Ultrasound-guided interventional procedures of the wrist and hand: anatomy, indications, and techniques. Phys Med Rehabil Clin N Am. 2016;27:589–605.CrossRefPubMedGoogle Scholar
  51. 51.
    Rojo-Manaute JM, Capa-Grasa A, Chana-Rodríguez F, Perez-Mañanes R, Rodriguez-Maruri G, Sanz-Ruiz P, Muñoz-Ledesma J, Aburto-Bernardo M, Esparragoza-Cabrera L, Cerro-Gutiérrez MD, Vaquero-Martín J. Ultra-minimally invasive ultrasound-guided carpal tunnel release: a randomized clinical trial. J Ultrasound Med. 2016;35:1149–57.CrossRefPubMedGoogle Scholar
  52. 52.
    Kelly S, Humby F, Filer A, Ng N, Di Cicco M, Hands RE, Rocher V, Bombardieri M, D’Agostino MA, McInnes IB, Buckley CD, Taylor PC, Pitzalis C. Ultrasound-guided synovial biopsy: a safe, well-tolerated and reliable technique for obtaining high-quality synovial tissue from both large and small joints in early arthritis patients. Ann Rheum Dis. 2015;74:611–7.CrossRefPubMedGoogle Scholar
  53. 53.
    Balint PV, Mandl P. Chapter 23: interventional musculoskeletal ultrasound. In: D’Agostino MA, Wakefield RJ, editors. Essential applications of ultrasound in rheumatology. Philadelphia: Elsevier; 2010. p. 292–314.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Emilio Filippucci
    • 1
  • Peter Mandl
    • 2
  • Peter Vince Balint
    • 3
  • Walter Grassi
    • 1
  1. 1.Clinica ReumatologicaUniversità Politecnica delle Marche, Ospedale “C. Urbani”AnconaItaly
  2. 2.Division of Rheumatology, Department of Internal Medicine IIIMedical University of ViennaViennaAustria
  3. 3.3rd Rheumatology DepartmentNational Institute of Rheumatology and PhysiotherapyBudapestHungary

Personalised recommendations