Skip to main content

Basic Sonopathology and Implementing Musculoskeletal Ultrasound into Clinical Practice

  • Chapter
  • First Online:
Musculoskeletal Ultrasound in Rheumatology Review

Abstract

Knowledge of the appearance of normal anatomy is critical before identifying abnormal pathology. This chapter reviews the definitions and appearance of general sonographic findings that correspond to commonly encountered rheumatologic pathologies, its associated conditions, and supporting literature. Once normal and pathologic sonoanatomy is recognized, learning how to incorporate your new skill set into your daily clinical practice in a safe and efficient way will expand your ability to help differentiate diagnoses for your patients.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Wakefield RJ, Balint PV, Szkudlarek M, et al. Musculoskeletal ultrasound including definitions for ultrasonographic pathology. J Rheumatol. 2005;32:2485–7.

    PubMed  Google Scholar 

  2. Naredo E, Wakefield RJ, Iagnocco A, et al. The OMERACT ultrasound task force – status and perspectives. J Rheumatol. 2011;38:2063–7.

    Article  PubMed  Google Scholar 

  3. Dalvi SR, Moser DW, Samuels J. Ultrasound and treatment algorithms of RA and JIA. Rheum Dis Clin N Am. 2013;39:669–88.

    Article  Google Scholar 

  4. Bruyn GA, Pineda C, Hernandez-Diaz C, et al. Validity of ultrasonography and measures of adult shoulder function and reliability of ultrasonography in detecting shoulder synovitis in patients with rheumatoid arthritis using magnetic resonance imaging as a gold standard. Arthritis Care Res. 2010;62:1079–86.

    Article  CAS  Google Scholar 

  5. Szkudlarek M, Klarlund M, Narvestad E, et al. Ultrasonography of the metacarpophalangeal and proximal interphalangeal joints in rheumatoid arthritis: a comparison with magnetic resonance imaging, conventional radiography and clinical examination. Arthritis Res Ther. 2006;8:R52.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Terslev L, Torp-Pedersen S, Savnik A, et al. Doppler ultrasound and magnetic resonance imaging of synovial inflammation of the hand in rheumatoid arthritis: a comparative study. Arthritis Rheum. 2003;48:2434–41.

    Article  PubMed  CAS  Google Scholar 

  7. Karim Z, Wakefield RJ, Quinn M, et al. Validation and reproducibility of ultrasonography in the detection of synovitis in the knee: a comparison with arthroscopy and clinical examination. Arthritis Rheum. 2004;50:387–94.

    Article  PubMed  CAS  Google Scholar 

  8. Wakefield RJ, Freeston JE, O’Connor P, et al. The optimal assessment of the rheumatoid arthritis hindfoot: a comparative study of clinical examination, ultrasound and high field MRI. Ann Rheum Dis. 2008;67:1678–82.

    Article  PubMed  CAS  Google Scholar 

  9. Naredo E, Moller I, Moragues C, et al. Interobserver reliability in musculoskeletal ultrasonography: results from a “Teach the Teachers” rheumatologist course. Ann Rheum Dis. 2006;65:14–9.

    Article  PubMed  CAS  Google Scholar 

  10. Cheung PP, Dougados M, Gossec L. Reliability of ultrasonography to detect synovitis in rheumatoid arthritis: a systematic literature review of 35 studies (1,415 patients). Arthritis Care Res. 2010;62:323–34.

    Article  Google Scholar 

  11. Brown AK. Using ultrasonography to facilitate best practice in diagnosis and management of RA. Nat Rev Rheumatol. 2009;5:698–706.

    Article  PubMed  Google Scholar 

  12. Walther M, Harms H, Krenn V, et al. Correlation of power Doppler sonography with vascularity of the synovial tissue of the knee joint in patients with osteoarthritis and rheumatoid arthritis. Arthritis Rheum. 2001;44:331–8.

    Article  PubMed  CAS  Google Scholar 

  13. Walther M, Harms H, Krenn V, et al. Synovial tissue of the hip at power Doppler US: correlation between vascularity and power Doppler US signal. Radiology. 2002;225:225–31.

    Article  PubMed  Google Scholar 

  14. Naredo E, Bonilla G, Gamero F, et al. Assessment of inflammatory activity in rheumatoid arthritis: a comparative study of clinical evaluation with grey scale and power Doppler ultrasonography. Ann Rheum Dis. 2005;64:375–81.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  15. Backhaus M, Burmester GR, Sandrock D, et al. Prospective two year follow up study comparing novel and conventional imaging procedures in patients with arthritic finger joints. Ann Rheum Dis. 2002;61:895–904.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  16. Freeston JE, Brown AK, Hensor EM, et al. Extremity magnetic resonance imaging assessment of synovitis (without contrast) in rheumatoid arthritis may be less accurate than power Doppler ultrasound. Ann Rheum Dis. 2008;67:1351.

    Article  PubMed  CAS  Google Scholar 

  17. Boutry N, Lardé A, Lapègue F, et al. Magnetic resonance imaging appearance of the hands and feet in patients with early rheumatoid arthritis. J Rheumatol. 2003;30:671–9.

    PubMed  Google Scholar 

  18. Schmidt WA, Schicke B, Ostendorf B, et al. Low-field MRI versus ultrasound: which is more sensitive in detecting inflammation and bone damage in MCP and MTP joints in mild or moderate rheumatoid arthritis? Clin Exp Rheumatol. 2013;31:91–6.

    PubMed  Google Scholar 

  19. Grassi W, Filippucci E, Farina A, Cervini C. Sonographic imaging of tendons. Arthritis Rheum. 2000;43:969–76.

    Article  PubMed  CAS  Google Scholar 

  20. Micu MC, Serra S, Fodor D, et al. Inter-observer reliability of ultrasound detection of tendon abnormalities at the wrist and ankle in patients with rheumatoid arthritis. Rheumatology (Oxford). 2011;50:1120–4.

    Article  Google Scholar 

  21. Bruyn GA, Möller I, Garrido J, et al. Reliability testing of tendon disease using two different scanning methods in patients with rheumatoid arthritis. Rheumatology. 2012;51:1655–61.

    Article  PubMed  Google Scholar 

  22. Boutry N, Morel M, Flipo RM, et al. Early rheumatoid arthritis: a review of MRI and sonographic findings. AJR Am J Roentgenol. 2007;189:1502–9.

    Article  PubMed  Google Scholar 

  23. Funck-Brentano T, Etchepare F, Joulin SJ, et al. Benefits of ultrasonography in the management of early arthritis: a cross-sectional study of baseline data from the ESPOIR cohort. Rheumatology (Oxford). 2009;48:1515–9.

    Article  Google Scholar 

  24. Scheel AK, Hermann KG, Ohrndorf S, et al. Prospective 7 year follow up imaging study comparing radiography, ultrasonography, and magnetic resonance imaging in rheumatoid arthritis finger joints. Ann Rheum Dis. 2006;65:595–600.

    Article  PubMed  CAS  Google Scholar 

  25. Wakefield RJ, Gibbon WW, Conaghan PG, et al. The value of sonography in the detection of bone erosions in patients with rheumatoid arthritis: a comparison with conventional radiography. Arthritis Rheum. 2000;43:2762–70.

    Article  PubMed  CAS  Google Scholar 

  26. Lopez-Ben R, Bernreuter WK, Moreland LW, Alarcon GS. Ultrasound detection of bone erosions in rheumatoid arthritis: a comparison to routine radiographs of the hands and feet. Skelet Radiol. 2004;33:80–4.

    Article  Google Scholar 

  27. Dohn UM, Ejbjerg BJ, Court-Payen M, et al. Are bone erosions detected by magnetic resonance imaging and ultrasonography true erosions? A comparison with computed tomography in rheumatoid arthritis metacarpophalangeal joints. Arthritis Res Ther. 2006;8:R110.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Ostergaard M, Szkudlarek M. Imaging in rheumatoid arthritis – why MRI and ultrasonography can no longer be ignored. Scandinavian J Rheumatol. 2003;32:63–73.

    Article  Google Scholar 

  29. Szkudlarek M, Court-Payen M, Jacobsen S, et al. Interobserver agreement in ultrasonography of the finger and toe joints in rheumatoid arthritis. Arthritis Rheum. 2003;48:955–62.

    Article  PubMed  Google Scholar 

  30. Gutierrez M, Filippucci E, Ruta S, et al. Inter-observer reliability of high-resolution ultrasonography in the assessment of bone erosions in patients with rheumatoid arthritis: experience of an intensive dedicated training programme. Rheumatology (Oxford). 2011;50:373–80.

    Article  Google Scholar 

  31. Hammer HB, Sveinsson M, Kongtorp AK, Kvien TK. A 78-joints ultrasonographic assessment is associated with clinical assessments and is highly responsive to improvement in a longitudinal study of patients with rheumatoid arthritis starting adalimumab treatment. Ann Rheum Dis. 2010;69:1349–51.

    Article  PubMed  CAS  Google Scholar 

  32. Perricone C, Ceccarelli F, Modesti M, et al. The 6-joint ultrasonographic assessment: a valid, sensitive-to-change and feasible method for evaluating joint inflammation in RA. Rheumatology (Oxford). 2012;51:866–73.

    Article  Google Scholar 

  33. Scire CA, Montecucco C, Codullo V, et al. Ultrasonographic evaluation of joint involvement in early rheumatoid arthritis in clinical remission: power Doppler signal predicts short-term relapse. Rheumatology (Oxford). 2009;48:1092–7.

    Article  CAS  Google Scholar 

  34. Naredo E, Rodriguez M, Campos C, et al. Validity, reproducibility, and responsiveness of a twelve-joint simplified power doppler ultrasonographic assessment of joint inflammation in rheumatoid arthritis. Arthritis Rheum. 2008;59:515–22.

    Article  PubMed  Google Scholar 

  35. Backhaus TM, Ohrndorf S, Kellner H, et al. The US7 score is sensitive to change in a large cohort of patients with rheumatoid arthritis over 12 months of therapy. Ann Rheum Dis. 2013;72(7):1163–9. Epub 2012 Sep 6.

    Article  PubMed  Google Scholar 

  36. Backhaus M, Ohrndorf S, Kellner H, et al. Evaluation of a novel 7-joint ultrasound score in daily rheumatologic practice: a pilot project. Arthritis Rheum. 2009;61:1194–201.

    Article  PubMed  CAS  Google Scholar 

  37. Iagnocco A, Naredo E, Wakefield R, et al. Responsiveness in rheumatoid arthritis. A report from the OMERACT 11 ultrasound workshop. J Rheumatol. 2014;41:379–82.

    Article  PubMed  Google Scholar 

  38. Ben-Artzi A, Kaeley GS, Ranganath VK. Ultrasound scoring of joint synovitis. Springer; 2021.

    Book  Google Scholar 

  39. Brown AK, Conaghan PG, Karim Z, et al. An explanation for the apparent dissociation between clinical remission and continued structural deterioration in rheumatoid arthritis. Arthritis Rheum. 2008;58:2958–67.

    Article  PubMed  CAS  Google Scholar 

  40. Naredo E, Collado P, Cruz A, et al. Longitudinal power Doppler ultrasonographic assessment of joint inflammatory activity in early rheumatoid arthritis: predictive value in disease activity and radiologic progression. Arthritis Rheum. 2007;57:116–24.

    Article  PubMed  Google Scholar 

  41. Naredo E, Moller I, Cruz A, et al. Power Doppler ultrasonographic monitoring of response to anti-tumor necrosis factor therapy in patients with rheumatoid arthritis. Arthritis Rheum. 2008;58:2248–56.

    Article  PubMed  Google Scholar 

  42. Taylor PC, Steuer A, Gruber J, et al. Comparison of ultrasonographic assessment of synovitis and joint vascularity with radiographic evaluation in a randomized, placebo-controlled study of infliximab therapy in early rheumatoid arthritis. Arthritis Rheum. 2004;50:1107–16.

    Article  PubMed  CAS  Google Scholar 

  43. Boyesen P, Haavardsholm EA, van der Heijde D, et al. Prediction of MRI erosive progression: a comparison of modern imaging modalities in early rheumatoid arthritis patients. Ann Rheum Dis. 2011;70:176–9.

    Article  PubMed  Google Scholar 

  44. Brown AK, Quinn MA, Karim Z, et al. Presence of significant synovitis in rheumatoid arthritis patients with disease-modifying antirheumatic drug-induced clinical remission: evidence from an imaging study may explain structural progression. Arthritis Rheum. 2006;54:3761–73.

    Article  PubMed  CAS  Google Scholar 

  45. Zufferey P, Moller B, Brulhart L, et al. Persistence of ultrasound synovitis in patients with rheumatoid arthritis fulfilling the DAS28 and/or the new ACR/EULAR RA remission definitions: results of an observational cohort study. Joint Bone Spine. 2014;81:426–32.

    Article  PubMed  Google Scholar 

  46. Saleem B, Brown AK, Keen H, et al. Should imaging be a component of rheumatoid arthritis remission criteria? A comparison between traditional and modified composite remission scores and imaging assessments. Ann Rheum Dis. 2011;70:792–8.

    Article  PubMed  Google Scholar 

  47. Meenagh G, Filippucci E, Iagnocco A, et al. Ultrasound imaging for the rheumatologist VIII. Ultrasound imaging in osteoarthritis. Clin Exp Rheumatol. 2007;25:172–5.

    PubMed  CAS  Google Scholar 

  48. Keen HI, Wakefield RJ, Conaghan PG. A systematic review of ultrasonography in osteoarthritis. Ann Rheum Dis. 2009;68:611–9.

    Article  PubMed  CAS  Google Scholar 

  49. Riecke BF, Christensen R, Torp-Pedersen S, et al. An ultrasound score for knee osteoarthritis: a cross-sectional validation study. Osteoarthr Cartil. 2014;22:1675–91.

    Article  CAS  Google Scholar 

  50. Keen HI, Lavie F, Wakefield RJ, et al. The development of a preliminary ultrasonographic scoring system for features of hand osteoarthritis. Ann Rheum Dis. 2008;67:651–5.

    Article  PubMed  CAS  Google Scholar 

  51. Keen HI, Wakefield RJ, Grainger AJ, et al. Can ultrasonography improve on radiographic assessment in osteoarthritis of the hands? A comparison between radiographic and ultrasonographic detected pathology. Ann Rheum Dis. 2008;67:1116–20.

    Article  PubMed  CAS  Google Scholar 

  52. Picerno V, Filippou G, Bertoldi I, et al. Prevalence of Baker’s cyst in patients with knee pain: an ultrasonographic study. Reumatismo. 2013;65:264–70.

    Article  Google Scholar 

  53. Artul S, Khazin F, Hakim J, Habib G. Ultrasonographic findings in a large series of patients with knee pain. J Clin Imaging Sci. 2014;4:45.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Conaghan PG, D’Agostino MA, Le Bars M, et al. Clinical and ultrasonographic predictors of joint replacement for knee osteoarthritis: results from a large, 3-year, prospective EULAR study. Ann Rheum Dis. 2010;69:644–7.

    Article  PubMed  CAS  Google Scholar 

  55. Kristoffersen H, Torp-Pedersen S, Terslev L, et al. Indications of inflammation visualized by ultrasound in osteoarthritis of the knee. Acta Radiol. 2006;47:281–6.

    Article  PubMed  CAS  Google Scholar 

  56. Moller I, Bong D, Naredo E, et al. Ultrasound in the study and monitoring of osteoarthritis. Osteoarthr Cartil. 2008;16(Suppl 3):S4–7.

    Article  Google Scholar 

  57. D’Agostino MA, Conaghan P, Le Bars M, et al. EULAR report on the use of ultrasonography in painful knee osteoarthritis. Part 1: prevalence of inflammation in osteoarthritis. Ann Rheum Dis. 2005;64:1703–9.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Atchia I, Kane D, Reed MR, Isaacs JD, Birrell F. Efficacy of a single ultrasound-guided injection for the treatment of hip osteoarthritis. Ann Rheum Dis. 2011;70:110–6.

    Article  PubMed  Google Scholar 

  59. Maheu E, Berenbaum F. Time for new outcome measures in hand osteoarthritis? Nat Clin Pract Rheumatol. 2009;5:136–8.

    PubMed  Google Scholar 

  60. Keen HI, Wakefield RJ, Grainger AJ, et al. An ultrasonographic study of osteoarthritis of the hand: synovitis and its relationship to structural pathology and symptoms. Arthritis Rheum. 2008;59:1756–63.

    Article  PubMed  Google Scholar 

  61. Kortekaas MC, Kwok WY, Reijnierse M, et al. In erosive hand osteoarthritis more inflammatory signs on ultrasound are found than in the rest of hand osteoarthritis. Ann Rheum Dis. 2013;72:930–4.

    Article  PubMed  Google Scholar 

  62. De Miguel E, Falcao S, Castillo C, et al. Enthesis erosion in spondyloarthritis is not a persistent structural lesion. Ann Rheum Dis. 2011;70(11):2008–10.

    Article  PubMed  Google Scholar 

  63. Aydin SZ, Bas E, Basi O, et al. Validation of ultrasound imaging for Achilles entheseal fibrocartilage in bovines and description of changes in humans with spondyloarthritis. Ann Rheum Dis. 2010;69(12):2165–8.

    Article  PubMed  Google Scholar 

  64. Falcao S, De Miguel E, Castillo-Gallego C, et al. Achilles enthesis ultrasound: the importance of the bursa in spondyloarthritis. Clin Exp Rheumatol. 2013;31(3):422–7.

    PubMed  Google Scholar 

  65. Spadaro A, Iagnocco A, Perrotta FM, et al. Clinical and ultrasonography assessment of peripheral enthesitis in ankylosing spondylitis. Rheumatology (Oxford). 2011;50:2080–6.

    Article  Google Scholar 

  66. Hamdi W, Chelli MB, Ghannouchi MM, et al. Performance of ultrasounds compared with radiographs to detect chronic enthesitis signs in patients with ankylosing spondylitis. Rheumatol Int. 2013;33:497–9.

    Article  PubMed  Google Scholar 

  67. Huang Z, Cao J, Li T, et al. Efficacy and safety of ultrasound-guided local injections of etanercept into entheses of ankylosing spondylitis patients with refractory Achilles enthesitis. Clin Exp Rheumatol. 2011;29(4):642–9.

    PubMed  CAS  Google Scholar 

  68. Aydin SZ, Karadag O, Filippucci E, et al. Monitoring Achilles enthesitis in ankylosing spondylitis during TNF-α antagonist therapy: an ultrasound study. Rheumatology (Oxford). 2010;49:578–82.

    Article  CAS  Google Scholar 

  69. Sakellariou G, Iagnocco A, Meenagh G, et al. Ultrasound imaging for the rheumatologist XXXVII. Sonographic assessment of the hip in ankylosing spondylitis patients. Clin Exp Rheumatol. 2012;30(1):1–5.

    PubMed  CAS  Google Scholar 

  70. Mohammedi A, Ghasemi-rad M, Aghdashi M, et al. Evaluation of disease activity in ankylosing spondylitis; diagnostic value of color Doppler ultrasonography. Skelet Radiol. 2013;42:219–24.

    Article  Google Scholar 

  71. Zhu J, Xing C, Jiang Y, et al. Evaluation of complex appearance in vascularity of sacroiliac joint in ankylosing spondylitis by color Doppler ultrasonography. Rheumatol Int. 2012;32:69–72.

    Article  PubMed  Google Scholar 

  72. Hu Y, Zhu J, Xue Q, et al. Scanning of the sacroiliac joint and enthesis by color Doppler ultrasonography in patients with ankylosing spondylitis. J Rheumatol. 2011;38:1651–5.

    Article  PubMed  Google Scholar 

  73. Jiang Y, Chen L, Zhu J, et al. Power Doppler ultrasonography in the evaluation of infliximab treatment for sacroiliitis in patients with ankylosing spondylitis. Rheumatol Int. 2013;33:2025–9.

    Article  PubMed  CAS  Google Scholar 

  74. Freeston JE, Coates LC, Nam JL, et al. Is there subclinical synovitis in early psoriatic arthritis? A clinical comparison with gray-scale and power Doppler ultrasound. Arthritis Care Res. 2014;66(3):432–9.

    Article  Google Scholar 

  75. Freeston JE, Coates LC, Helliwell PS, et al. Is there subclinical enthesitis in early psoriatic arthritis? A clinical comparison with power Doppler ultrasound. Arthritis Care Res. 2012;64(10):1617–21.

    Article  CAS  Google Scholar 

  76. Bandinelli F, Prignano F, Bonciani D, et al. Ultrasound detects occult entheseal involvement in early psoriatic arthritis independently of clinical features and psoriasis severity. Clin Exp Rheumatol. 2013;31(2):219–4.

    PubMed  Google Scholar 

  77. Gladman DD, Shuckett R, Russell MI. Psoriatic arthritis (PSA) – an analysis of 220 patients. Q J Med. 1987;62(238):127–41.

    PubMed  CAS  Google Scholar 

  78. De Simone C, Caldarola G, D’Agostino M, et al. Usefulness of ultrasound imaging in detecting psoriatic arthritis of fingers and toes in patients with psoriasis. Clin Dev Immunol. 2011;2011:390726.

    Article  PubMed  Google Scholar 

  79. Naredo E, Moller I, De Miguel E, et al. High prevalence of ultrasonographic synovitis and enthesopathy in patients with psoriasis without psoriatic arthritis: a prospective case-control study. Rheumatology (Oxford). 2011;50:1838–48.

    Article  Google Scholar 

  80. Tinazzi I, McGonagle D, Biasi D, et al. Preliminary evidence that subclinical enthesopathy may predict psoriatic arthritis in patients with psoriasis. J Rheumatol. 2011;38(12):2691–2.

    Article  PubMed  Google Scholar 

  81. Gutierrez M, Filippucci E, De Angelis R, et al. Subclinical entheseal involvement in patients with psoriasis: an ultrasound study. Semin Arthritis Rheum. 2011;40:407–12.

    Article  PubMed  Google Scholar 

  82. El Miedany Y, El Gaafary M, Youssef S, et al. Tailored approach to early psoriatic arthritis patients: clinical and ultrasonographic predictors for structural joint damage. Clin Rheumatol. 2015;34(2):307–13.

    Article  PubMed  Google Scholar 

  83. Bonifati C, Elia F, Graceffa D, et al. Clinical and contrast-enhanced ultrasound echography outcomes in psoriatic arthritis patients after one year of continuous therapy with anti-TNF drugs. ISRN Dermatol. 2014;2014:932721. eCollection 2014.

    Article  PubMed  PubMed Central  Google Scholar 

  84. Riente L, Delle Sedie A, Sakellariou G, et al. Ultrasound imaging for the rheumatologist XXXVIII. Sonographic assessment of the hip in psoriatic arthritis patients. Clin Exp Rheumatol. 2012;30(2):152–5.

    PubMed  Google Scholar 

  85. Iagnocco A, Spadaro A, Marchesoni A, et al. Power Doppler ultrasonographic evaluation of enthesitis in psoriatic arthritis. A multi-center study. Joint Bone Spine. 2012;79:323–34.

    Article  Google Scholar 

  86. Eder L, Kaeley GS, Aydin SZ. Development and validation of a sonographic enthesitis instrument in psoriatic arthritis: the GRAPPA diagnostic ultrasound Enthesitis tool (DUET) project. J Rheumatol. 2020;96:50–2.

    Article  Google Scholar 

  87. Husic R, Gretler J, Felber A, et al. Disparity between ultrasound and clinical findings in psoriatic arthritis. Ann Rheum Dis. 2014;73(8):1529–36.

    Article  PubMed  Google Scholar 

  88. Kaeley GS. Ultrasound imaging module: report from the GRAPPA 2012 annual meeting. J Rheumatol. 2013;40:1450–2.

    Article  PubMed  Google Scholar 

  89. Bakewell CJ, Olivieri I, Aydin SZ, et al. Ultrasound and magnetic resonance imaging in the evaluation of psoriatic dactylitis: status and perspectives. J Rheumatol. 2013;40:1951–7.

    Article  PubMed  Google Scholar 

  90. Healy PJ, Groves C, Chandramohan M, Helliwell PS. MRI changes in psoriatic dactylitis – extent of pathology, relationship to tenderness and correlation with clinical indices. Rheumatology. 2008;47:92–5.

    Article  PubMed  CAS  Google Scholar 

  91. Olivieri I, Scarano E, Padula A, et al. Fast spin echo-T2-weighted sequences with fat saturation in toe dactylitis of spondyloarthritis. Clin Rheumatol. 2008;27:1141–5.

    Article  PubMed  Google Scholar 

  92. Olivieri I, Barozzi L, Favaro L, et al. Dactylitis in patients with seronegative spondyloarthropathy. Assessment by ultrasonography and magnetic resonance imaging. Arthritis Rheum. 1995;39:1524–8.

    Article  Google Scholar 

  93. Kane D, Greaney T, Bresnihan B, et al. Ultrasonography in the diagnosis and management of psoriatic dactylitis. J Rheumatol. 1999;26:1746–51.

    PubMed  CAS  Google Scholar 

  94. Jevtic V, Watt I, Rozman B, et al. Distinctive radiological features of small hand joints in rheumatoid arthritis and seronegative spondyloarthritis demonstrated by contrast-enhanced (Gd-DTPA) magnetic resonance imaging. Skelet Radiol. 1995;24:351–5.

    Article  CAS  Google Scholar 

  95. Fournie B, Margarit Coll N, Champetier De Ribes TL, et al. Extrasynovial ultrasound abnormalities in the psoriatic finger. Prospective comparative power-doppler study versus rheumatoid arthritis. Joint Bone Spine. 2006;73:527–31.

    Article  PubMed  Google Scholar 

  96. Gutierrez M, Wortsman X, Filippucci E, et al. High frequency sonography in the evaluation of psoriasis: nail and skin involvement. J Ultrasound Med. 2009;28(11):1569–74.

    Article  PubMed  Google Scholar 

  97. Wortsman X, Jemec G. Common inflammatory diseases of the skin: from the skin to the screen. Adv Psoriasis Inflamm Skin Dis. 2010;2:9–15.

    Google Scholar 

  98. Sandobal C, Carbo E, Iribas J, et al. Ultrasound nail imaging on patients with psoriasis and psoriatic arthritis compared with rheumatoid arthritis and control subjects. J Clin Rheumatol. 2014;20(1):21–4.

    Article  PubMed  Google Scholar 

  99. Aydin SB, Castillo-Gallego C, Ash ZR, et al. Ultrasonographic assessment of nail in psoriatic disease shows a link between onychopathy and distal interphalangeal joint extensor tendon enthesopathy. Dermatology. 2012;225:231–5.

    Article  PubMed  Google Scholar 

  100. Klauser AS, Wipfler E, Dejaco C, et al. Diagnostic values of history and clinical examination to predict ultrasound signs of chronic and acute enthesitis. Clin Exp Rheumatol. 2008;26(4):548–53.

    PubMed  CAS  Google Scholar 

  101. Eder L, Jayaker J, Thavaneswaran A, et al. Is the Madrid Sonographic Enthesitis Index useful for differentiating psoriatic arthritis from psoriasis alone and healthy controls. J Rheumatol. 2014;41:466–72.

    Article  PubMed  Google Scholar 

  102. Ibrahim G, Groves C, Chandramohan M, et al. Clinical and ultrasound examination of the Leeds Enthesitis Index in PSoriatic arthritis and rheumatoid arthritis. ISRN Rheumatol. 2011;2011:731917.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  103. Schafer VS, Fleck M, Kellner H, et al. Evaluation of the novel ultrasound score for large joints in psoriatic arthritis and ankylosing spondylitis: six month experience in daily clinical practice. BMC Musculoskelet Disord. 2013;14:358.

    Article  PubMed  PubMed Central  Google Scholar 

  104. Ottaviani S, Gill G, Palazzo E, et al. Ultrasonography of shoulders in spondyloarthritis and rheumatoid arthritis: a case-control study. Joint Bone Spine. 2014;81:247–9.

    Article  PubMed  Google Scholar 

  105. Toprak H, Kilic E, Serter A, et al. Doppler US in rheumatic diseases with special emphasis on rheumatoid arthritis and spondyloarthritis. Diagn Interv Radiol. 2014;20:72–7.

    PubMed  Google Scholar 

  106. Ruta S, Felquer MLA, Rosa J, et al. Responsiveness to therapy change of a global ultrasound assessment in spondyloarthritis patients. Clin Rheumatol. 2015;34(1):125–32.

    Article  PubMed  Google Scholar 

  107. McCarty DJ, Hollander JL. Identification of urate crystals in gouty synovial fluid. Ann Intern Med. 1961;54:452–60.

    Article  PubMed  CAS  Google Scholar 

  108. Filippucci E, Di Geso L, Girolimetti R, Grassi W. Ultrasound in crystal-related arthritis. Clin Exp Rheumatol. 2014;32(1 Suppl 80):S42–7.

    Google Scholar 

  109. Delle Sedie A, Riente L, Iagnocco A, et al. Ultrasound imaging for the rheumatologist X. Ultrasound imaging in crystal-related arthropathies. Clin Exp Rheumatol. 2007;25(4):513–7.

    PubMed  CAS  Google Scholar 

  110. Neogi T, Jansen TLTA, Dalbeth N, et al. 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2015;74:1789–98.

    Article  PubMed  CAS  Google Scholar 

  111. Grassi W, Meenagh G, Pascual E, Filippucci E. “Crystal clear” – sonographic assessment of gout and calcium pyrophosphate deposition disease. Semin Arthritis Rheum. 2006;36:197–202.

    Article  PubMed  CAS  Google Scholar 

  112. Chen LX, Schumacher HR. Gout: can we create an evidence-based systematic approach to diagnosis and management? Best Pract Res Clin Rheumatol. 2006;20:673–84.

    Article  PubMed  Google Scholar 

  113. Filippucci E, Meenagh G, Delle Sedie A, et al. Ultrasound imaging for the rheumatologist XXXVI. Sonographic assessment of the foot in gout patients. Clin Exp Rheumatol. 2011;29(6):901–5.

    PubMed  Google Scholar 

  114. Wright SA, Filippucci E, McVeigh C, et al. High-resolution ultrasonography of the first metatarsal phalangeal joint in gout: a controlled study. Ann Rheum Dis. 2007;66:859–64.

    Article  PubMed  Google Scholar 

  115. Thiele RG, Schlesinger N. Diagnosis of gout by ultrasound. Rheumatology. 2007;46:1116–21.

    Article  PubMed  CAS  Google Scholar 

  116. Daboiko JC, Ouali B, Ouattara B. Use of ultrasound guidance in an inaugural acute gout of the hip joint; apropos of a west African case. J Clin Rheumatol. 2011;17(2):94–5.

    Article  PubMed  Google Scholar 

  117. Wakefield R, Emery P, Pease C. Gout related upper limb cellulitis: an ultrasound study. J Rheumatol. 2003;30(2):417–9.

    PubMed  Google Scholar 

  118. Le Goff B, Berthelot MJ, Andre V, Guillot P, Maugars Y. Ultrasonography for diagnosing atypical gout. Two case reports. Joint Bone Spine. 2008;75:610–2.

    Article  PubMed  Google Scholar 

  119. Aslam N, Lo S, McNab I. Gouty flexor tenosynovitis mimicking infection: a case report emphasizing the value of ultrasound in diagnosis. Acta Orthop Belg. 2004;70:368–70.

    PubMed  Google Scholar 

  120. Puig JG, de Miguel E, Castillo MC, et al. Asymptomatic hyperuricemia: impact of ultrasonography. Nuclosides Nucleotides Nucleic Acids. 2008;27(6–7):592–5.

    Article  CAS  Google Scholar 

  121. De Miguel E, Puig JG, Castillo C, et al. Diagnosis of gout in patients with asymptomatic hyperuricaemia: a pilot ultrasound study. Ann Rheum Dis. 2012;71(1):157–8.

    Article  PubMed  Google Scholar 

  122. Pineda C, Amezcua-Guerra LM, Solano C, et al. Joint and tendon subclinical involvement suggestive of gouty arthritis in asymptomatic hyperuricemia: an ultrasound controlled study. Arthritis Res Ther. 2011;13:R4.

    Article  PubMed  PubMed Central  Google Scholar 

  123. Ottaviani S, Allard A, Bardin T, Richette P. An exploratory ultrasound study of early gout. Clin Exp Rheumatol. 2011;29(5):816–32.

    PubMed  Google Scholar 

  124. Filippucci E, Gutierrez M, Georgescu D, et al. Hyaline cartilage involvement in patients with gout and calcium pyrophosphate deposition disease. An ultrasound study. Osteoarthr Cartil. 2009;17(2):178–81.

    Article  CAS  Google Scholar 

  125. Howard RG, Pillinger MH, Gyftopoulos S, et al. Reproducibility of musculoskeletal ultrasound for determining monosodium urate deposition: concordance between readers. Arthritis Care Res. 2011;63(10):1456–62.

    Article  CAS  Google Scholar 

  126. Rettenbecher T, Ennemoser S, Welrich H, et al. Diagnostic imaging of gout: comparison of high-resolution US versus conventional X-ray. Eur Radiol. 2008;18:621–30.

    Article  Google Scholar 

  127. Gruber M, Bodner G, Rath E, et al. Dual-energy computed tomography compared with ultrasound in the diagnosis of gout. Rheumatology (Oxford). 2014;53(1):173–9. Epub 2013 Oct 17.

    Article  CAS  Google Scholar 

  128. Gerster JC, Landry M, Dufresne L, Meuwly JY. Imaging of tophaceous gout: computed tomography provides specific images compared with magnetic resonance imaging and ultrasonography. Ann Rheum Dis. 2001;61:52–4.

    Article  Google Scholar 

  129. Bongartz T, Glazebrook KN, Kavros SJ, et al. Dual-energy CT for the diagnosis of gout: an accuracy and diagnostic yield study. Ann Rheum Dis. 2015;74:1072–7.

    Article  PubMed  CAS  Google Scholar 

  130. De Avila FE, Kubota ES, Sandim GB, et al. Ultrasound features of tophi in chronic tophaceous gout. Skelet Radiol. 2011;40:309–15.

    Article  Google Scholar 

  131. De Avila FE, Lopes MG, Mitraud SAV, et al. Ultrasound characteristics of gouty tophi in the olecranon bursa and evaluation of their reproducibility. Eur J Radiol. 2012;81:317–23.

    Article  Google Scholar 

  132. Dalbeth N, Schauer C, MacDonald P, et al. Methods of tophus assessment in clinical trials of gout: a systematic literature review and pictorial reference guide. Ann Rheum Dis. 2011;70(4):597–604. Epub 2011 Jan 7

    Article  PubMed  Google Scholar 

  133. Balbir Gurman A, Nahir AM, Braun-Moscovici Y, Soudack M. Sonographic features of a tophaceous nodule. Isr Med Assoc J. 2005;7:746–7.

    PubMed  Google Scholar 

  134. Kunkel G. Tophaceous gout mimicking osteomyelitis; the value of musculoskeletal ultrasound in establishing the diagnosis. J Clin Rheumatol. 2010;16(6):295–7.

    Article  PubMed  Google Scholar 

  135. Gutierrez M, Di Geso L, Filippucci E, Grassi W. Calcium pyrophosphate crystals detected by ultrasound in patients without radiographic evidence of cartilage calcifications. J Rheumatol. 2010;37(2):2602–3.

    Article  PubMed  Google Scholar 

  136. Sofka CM, Adler RS, Cordasco FA. Ultrasound diagnosis of chondrocalcinosis in the knee. Skelet Radiol. 2002;31:43–5.

    Article  Google Scholar 

  137. Filippou G, Frediani B, Gallo A, et al. A “new” technique for the diagnosis of chondrocalcinosis of the knee: sensitivity and specificity of high-frequency ultrasonography. Ann Rheum Dis. 2007;66:1126–8.

    Article  PubMed  PubMed Central  Google Scholar 

  138. Filippou G, Filippucci E, Tardella M, et al. Extent and distribution of CPP deposits in patients affected by calcium pyrophosphate dehydrate deposition disease: an ultrasonographic study. Ann Rheum Dis. 2013;72:1836–9.

    Article  PubMed  Google Scholar 

  139. Ellaban AS, Kamel SR, Abo Omar HAS, et al. Ultrasonographic findings of Achilles tendon and plantar fascia in patients with calcium pyrophosphate deposition disease. Clin Rheumatol. 2012;31:697–704.

    Article  Google Scholar 

  140. Checa A, Wong H, Chun W. Sonographic characterization of mixed crystal arthropathy due to monosodium urate and calcium pyrophosphate dehydrate: the triple-contour sign. J Ultrasound Med. 2011;30:859–67.

    Article  Google Scholar 

  141. American Institute of Ultrasound in Medicine. AIUM practice guidelines for cleaning and preparing external- and internal-use ultrasound transducers and equipment between patients as well as safe handling and use of ultrasound coupling gel. Reapproved 2020. aium.org/officialstatements/57.

  142. American Institute of Ultrasound in Medicine. AIUM practice guideline for documentation of an ultrasound examination. J Ultrasound Med. 2014;33:1098–102.

    Article  Google Scholar 

  143. American Institute of Ultrasound in Medicine. AIUM practice guidelines for selected ultrasound-guided procedures. 2014. aium.org/resources/guidelines/usguidedprocedures.pdf.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jonathan Samuels .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Samuels, J., Torralba, K.D., Kohler, M.J. (2021). Basic Sonopathology and Implementing Musculoskeletal Ultrasound into Clinical Practice. In: Kohler, M.J. (eds) Musculoskeletal Ultrasound in Rheumatology Review. Springer, Cham. https://doi.org/10.1007/978-3-030-73555-5_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-73555-5_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-73554-8

  • Online ISBN: 978-3-030-73555-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics