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Intra-articular discontinuity of the bone surface is visible in 2 perpendicular planes OMERACT, Wakefield and coll. J Rheumatol 2005. ULTRASOUND DEFINED.

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Presentation on theme: "Intra-articular discontinuity of the bone surface is visible in 2 perpendicular planes OMERACT, Wakefield and coll. J Rheumatol 2005. ULTRASOUND DEFINED."— Presentation transcript:

1 Intra-articular discontinuity of the bone surface is visible in 2 perpendicular planes OMERACT, Wakefield and coll. J Rheumatol ULTRASOUND DEFINED EROSION IN RA dorsal longitudinal (A) and transverse longitudinal (B) scans A B

2 Erosion of the 2 MC visible in two perpendicular planes: dorsal longitudinal (A) and transverse longitudinal (B) scans A B METACARPAL HEAD

3 Erosion of the 2 MC visible in a longitudinal dorsal scan METACARPAL HEAD

4 Erosion of the 2 MC visible in a longitudinal dorsal scan with inflammatory synovitis and vessels inside the erosion METACARPAL HEAD

5 Erosion of the 2 MC visible in a longitudinal dorsal scan with inflammatory synovitis and vessels inside the erosion

6 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

7 METACARPAL HEAD A B Erosion of the 5 MC visible in two perpendicular planes: dorsal longitudinal (A) and transverse longitudinal (B) scans

8 Several coalescent erosions of the 2 MC visible in two perpendicular planes: dorsal longitudinal (A) and transverse longitudinal (B) scans METACARPAL HEAD A B

9 Several coalescent erosions of the 3 MC visible in two perpendicular planes: dorsal longitudinal (A) and transverse longitudinal (B) scans A B

10 Dorsal Radius: large erosion in a transverse scan WRIST

11 Lunatum: several coalescent erosions in longitudinal (A) and transverse (B) palmar scans A B

12 Dorsal Ulna, transverse scan: several coalescent erosions WRIST

13 Processus Styloideus of ulna: several coalescent erosions: longitudinal dorsal (A) and transverse dorsal (B) scans A B

14 ELBOW Radial head in anterior longitudinal scan : large erosion

15 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

16 ENTHESOPHYTES Enthesophyte of the 2 MC visible in a longitudinal dorsal scan (arrow)

17 IRREGULARITIES, EROSION OR PRE-EROSION ? Radial aspect of 2 nd MC : longitudinal scan (A) and transverse scan (B) A B


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