Musculoskeletal ultrasonography in gout

Gout is a frequent inflammatory disease induced by the deposition of monosodium urate crystals in joints and extra-articular tissues. The natural history of the disease includes four different phases: asymptomatic hyperuricemia, acute attacks, intercritical phase, and chronic tophaceous gout. Imaging techniques have several applications in the diagnosis, clinical monitoring and management of the disease but particularly, musculoskeletal ultrasound is able to detect a wide set of abnormalities in gout. This review reports the most relevant findings detectable by ultrasound and the current available data in the literature regarding the role of musculoskeletal ultrasound in gout.

Musculoskeletal ultrasonography in gout

Abstract Gout is a frequent inflammatory disease induced by the deposition of monosodium urate crystals in joints and extraarticular tissues. The natural history of the disease includes four different phases: asymptomatic hyperuricemia, acute attacks, intercritical phase, and chronic tophaceous gout. Imaging techniques have several applications in the diagnosis, clinical monitoring and management of the disease but, particularly, musculoskeletal ultrasound is able to detect a wide set of abnormalities in gout. This review reports the most relevant findings detectable by ultrasound and the current available data in the literature regarding the role of musculoskeletal ultrasound in gout

Imaging modalities in osteoarthritis

Osteoarthritis (OA) is a degenerative and progressive joint disease that causes physical disability and impaired quality of life. It most commonly affects the elderly population. Classically, the knees, hips, lumbar-sacral spine, neck, feet and hands are involved. Imaging techniques have been demonstrated to play an important role in the diagnosis and monitoring of OA. The radiographic abnormalities of OA are joint space narrowing, osteophytes, subchondral cysts and subchondral sclerosis. X-ray examination is fast, inexpensive and readily applicable in almost all settings. Magnetic resonance imaging is a non-invasive technique that allows direct visualisation of all components of the joint. This imaging technique has the ability to image, with higher sensitivity than X-ray, morphological changes in cartilage, bone, bone marrow and surrounding soft-tissue structures (such as ligaments, synovium and menisci). Ultrasound is commonly used in daily clinical practice to evaluate and monitor patients with OA because is a non-invasive, realtime imaging tool that shows the presence of many pathological features of OA involving the articular cartilage, bony cortex and synovial tissue, and allows injection into OA joints under guidance; moreover, compared with X-ray, ultrasound enables multiplanar and dynamic joint examination. Computed tomography and scintigraphy do not play an important role in the assessment of patients with OA; indeed, only limited data are available about the relevance of these techniques for the evaluation of chronic joint diseases. In conclusion, X-ray remains the gold standard imaging technique in daily clinical practice and in clinical trials for the evaluation of patients with OA owing to its accessibility, low cost and reproducibility. © Touch Briefings 2011

Musculoskeletal ultrasound in the evaluation of Polymyalgia Rheumatica

Polymyalgia rheumatica (PMR) is a relatively frequent disease affecting individuals older than 50 years and is characterized by inflammatory involvement of the shoulder and hip girdles and the neck. Clinical manifestations are represented by pain and morning stiffness in this regions. An extensive and comprehensive assessment of the inflammatory status is crucial in PMR patients, including imaging evaluation. This narrative review reports the current available data in the literature about the role of musculoskeletal ultrasound in PMR

"In sickness and in health": the peculiar occurrence of polymyalgia rheumatica in married cohabiting couples-a case series and review of the literature.

Polymyalgia rheumatica (PMR) is an inflammatory rheumatic disorder in elderly people. It is frequently associated with giant-cell arteritis (GCA), although it is still debated if they are the same disease or two distinct pathologies. The etiology of PMR remains challenging, although current knowledge supports the role of both genetic and environmental factors. Among these, there is evidence that infectious agents could trigger the disease's onset in some cases. We describe the peculiar case where PMR occurred in two Italian married and cohabiting couples and provide a review of the literature for similar cases. This is the first reported occurrence of PMR in two conjugal pairs in Italy. Moreover, in the second case, the wife presented PMR associated with GCA. To date, seven cases of PMR and two of GCA in married couples are described in the literature. The occurrence of PMR in both a husband and a wife supports the pathogenetic role of an environmental factor

Case report Unilateral painful, swollen and erythematosus knee. Case report

Abstract Musculoskeletal ultrasound (US) is gaining an increasing role in the assessment of a variegate set of joint and periarticular soft tissues abnormalities in rheumatology. In addition, US represents a useful technique in guiding local procedures such as aspiration of fluid collections and injections within the joints and periarticular musculoskeletal structures. We recently performed US in a patient with unilateral painful, swollen and erythematosus knee. Pre-patellar bursitis was demonstrated, without any signs of intra-articular abnormalities. US-guided aspiration of local effusion was performed; synovial fluid analysis demonstrated septic bursitis. Appropriate treatment determined the complete remission

Genetics and ultrasound in rheumatoid arthritis

[No abstract available