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Thumb ultrasound: Technique and pathologies

View Article: PubMed Central - PubMed

ABSTRACT

Ultrasound is ideally suited for the assessment of complex anatomy and pathologies of the thumb. Focused and dynamic thumb ultrasound can provide a rapid real-time diagnosis and can be used for guided treatment in certain clinical situations. We present a simplified approach to scanning technique for thumb-related pathologies and illustrate a spectrum of common and uncommon pathologies encountered.

No MeSH data available.


Related in: MedlinePlus

Inflammatory arthritis of the thumb in a HLA-B27 positive patient (A-E). Long axis (A) ultrasound view of the first carpometacarpal joint shows synovial thickening (arrow) with increased vascularity on Doppler. Long axis ultrasound images of the volar aspect of metacarpophalengeal joint without (B) and with pressure (C) shows displaced joint fluid (arrow in B) and minimal synovium with increased vascularity (open arrow in C). Long axis ultrasound view of the metacarpophalengeal joint (D) shows periarticular erosion (small arrow). Antero-posterior radiograph (E) of the same patient does not reveal any abnormality
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Figure 2: Inflammatory arthritis of the thumb in a HLA-B27 positive patient (A-E). Long axis (A) ultrasound view of the first carpometacarpal joint shows synovial thickening (arrow) with increased vascularity on Doppler. Long axis ultrasound images of the volar aspect of metacarpophalengeal joint without (B) and with pressure (C) shows displaced joint fluid (arrow in B) and minimal synovium with increased vascularity (open arrow in C). Long axis ultrasound view of the metacarpophalengeal joint (D) shows periarticular erosion (small arrow). Antero-posterior radiograph (E) of the same patient does not reveal any abnormality

Mentions: These joints are evaluated for any effusion, synovial thickening, erosions, osteophytes, articular cartilage defect, bony avulsion, or alignment abnormality. Joint effusion and synovial proliferation can be seen in inflammatory arthritis, degenerative joint disease (DJD), or infective arthritis. Synovitis is usually more echogenic and exhibits Doppler signal in the active phase [Figure 2A]. Joint effusion is hypoechoic, avascular, and expelled from the joint recess with transducer compression [Figure 2B and C]. Erosions [Figure 2D] are noted in inflammatory arthritis whereas osteophytes are more specific for DJD. Ultrasound and plain radiographs help in staging of DJD, which gives rationale for treatment.[1] Ultrasound features of infective arthritis include synovitis, effusion, and subperiosteal collection with the final diagnosis by ultrasound-guided diagnostic joint aspiration.


Thumb ultrasound: Technique and pathologies
Inflammatory arthritis of the thumb in a HLA-B27 positive patient (A-E). Long axis (A) ultrasound view of the first carpometacarpal joint shows synovial thickening (arrow) with increased vascularity on Doppler. Long axis ultrasound images of the volar aspect of metacarpophalengeal joint without (B) and with pressure (C) shows displaced joint fluid (arrow in B) and minimal synovium with increased vascularity (open arrow in C). Long axis ultrasound view of the metacarpophalengeal joint (D) shows periarticular erosion (small arrow). Antero-posterior radiograph (E) of the same patient does not reveal any abnormality
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5036340&req=5

Figure 2: Inflammatory arthritis of the thumb in a HLA-B27 positive patient (A-E). Long axis (A) ultrasound view of the first carpometacarpal joint shows synovial thickening (arrow) with increased vascularity on Doppler. Long axis ultrasound images of the volar aspect of metacarpophalengeal joint without (B) and with pressure (C) shows displaced joint fluid (arrow in B) and minimal synovium with increased vascularity (open arrow in C). Long axis ultrasound view of the metacarpophalengeal joint (D) shows periarticular erosion (small arrow). Antero-posterior radiograph (E) of the same patient does not reveal any abnormality
Mentions: These joints are evaluated for any effusion, synovial thickening, erosions, osteophytes, articular cartilage defect, bony avulsion, or alignment abnormality. Joint effusion and synovial proliferation can be seen in inflammatory arthritis, degenerative joint disease (DJD), or infective arthritis. Synovitis is usually more echogenic and exhibits Doppler signal in the active phase [Figure 2A]. Joint effusion is hypoechoic, avascular, and expelled from the joint recess with transducer compression [Figure 2B and C]. Erosions [Figure 2D] are noted in inflammatory arthritis whereas osteophytes are more specific for DJD. Ultrasound and plain radiographs help in staging of DJD, which gives rationale for treatment.[1] Ultrasound features of infective arthritis include synovitis, effusion, and subperiosteal collection with the final diagnosis by ultrasound-guided diagnostic joint aspiration.

View Article: PubMed Central - PubMed

ABSTRACT

Ultrasound is ideally suited for the assessment of complex anatomy and pathologies of the thumb. Focused and dynamic thumb ultrasound can provide a rapid real-time diagnosis and can be used for guided treatment in certain clinical situations. We present a simplified approach to scanning technique for thumb-related pathologies and illustrate a spectrum of common and uncommon pathologies encountered.

No MeSH data available.


Related in: MedlinePlus