intra-articular discontinuity of the bone surface is visible in 2 perpendicular planes omeract,...
TRANSCRIPT
Intra-articular discontinuity of the bone surface is visible in 2 perpendicular planes OMERACT, Wakefield and coll. J Rheumatol 2005.
ULTRASOUND DEFINED EROSION IN RA
dorsal longitudinal (A) and transverse longitudinal (B) scans
A B
Erosion of the 2 MC visible in two perpendicular planes: dorsal longitudinal (A) and transverse longitudinal (B) scans
A B
METACARPAL HEAD
Erosion of the 2 MC visible in a longitudinal dorsal scan
METACARPAL HEAD
Erosion of the 2 MC visible in a longitudinal dorsal scan with inflammatory synovitis and vessels inside the erosion
METACARPAL HEAD
METACARPAL HEAD
Erosion of the 2 MC visible in a longitudinal dorsal scan with inflammatory synovitis and vessels inside the erosion
METACARPAL HEAD
Erosion of the 2 MC visible in a longitudinal dorsal scan in B mode (A) and with Doppler (B): inflammatory synovitis and vessels inside the erosion
A
B
METACARPAL HEAD
A B
Erosion of the 5 MC visible in two perpendicular planes: dorsal longitudinal (A) and transverse longitudinal (B) scans
Several coalescent erosions of the 2 MC visible in two perpendicular planes: dorsal longitudinal (A) and transverse longitudinal (B) scans
METACARPAL HEAD
A B
METACARPAL HEAD
Several coalescent erosions of the 3 MC visible in two perpendicular planes: dorsal longitudinal (A) and transverse longitudinal (B) scans
A B
Dorsal Radius: large erosion in a transverse scan
WRIST
WRIST
Lunatum: several coalescent erosions in longitudinal (A) and transverse (B) palmar scans
A B
Dorsal Ulna, transverse scan: several coalescent erosions
WRIST
WRIST
Processus Styloideus of ulna: several coalescent erosions: longitudinal dorsal (A) and transverse dorsal (B) scans
A B
ELBOW
Radial head in anterior longitudinal scan : large erosion
Actual limitations
• Acoustic window• Pitfalls
– physiological vessel bone channels, normal irregularities of cortical bone, grooves, sesamoids
• Co-existent OA may be confused with erosions – pseudo-erosions, osteophytes
ENTHESOPHYTES
Enthesophyte of the 2 MC visible in a longitudinal dorsal scan (arrow)
IRREGULARITIES, EROSION OR PRE-EROSION ?
Radial aspect of 2nd MC : longitudinal scan (A) and transverse scan (B)
A B