The Case A 47-year-old woman presented with a one-year history of bilateral submandibular gland swelling, mild symptoms of xerostomia and xerophthalmia and arthralgias in her fingers. A review of systems was otherwise unremarkable. On physical examination, her submandibular glands on both sides were enlarged and had a firm texture. Her parotid glands were normal, as…
A Primer on Imaging in Myositis
In medicine, as in advertising, pictures can be worth a thousand words. From arthritis to vasculitis, imaging studies have been variably employed to aid in the diagnosis, treatment, risk stratification and prognostication of patients with rheumatic and musculoskeletal disorders. The same holds true with the idiopathic inflammatory myopathies (IIM), in which the clinical utility is…
Sonographic Diagnosis of Knuckle Pads
The Case A 56-year-old white woman was evaluated for a one-year history of painless bumps on the dorsal aspect of the proximal interphalangeal (PIP) joints of both hands and suspected flexor tenosynovitis in her palms. On examination, small cystic nodules without erythema or tenderness were present on the dorsal aspect of several PIP joints (see…
Imaging Modalities in Gout: How to Use them in Clinical Practice
This EULAR 2022 session discussed the increasing role of imaging in the diagnosis of gout.
The Role Ultrasound Imaging Plays in Diagnosing Hemangiomas
A 17-year-old woman presents with chronic finger pain experienced over six months that is worse in the mornings. On physical exam, the patient has no joint swelling, pain on range of motion or limitation of range of motion in any of her finger joints. She has a tender, subcutaneous, firm, flesh-colored nodule on the lateral…
The Power of Power Doppler: Ultrasound Imaging in RA
At the 17th Annual Advances in the Diagnosis & Treatment of the Rheumatic Diseases meeting, Dana DiRenzo, MD, MHS, RhMSUS, discussed the use of ultrasound imaging in patients with inflammatory arthritis.
Insights Into Ulnar Artery Occlusion in Systemic Sclerosis
A 51-year-old man with a history of limited systemic sclerosis with Raynaud’s phenomenon and pulmonary hypertension being treated with tadalafil and macitentan presented to a clinic with ulceration of his right pinkie. The patient had injured the finger two months earlier. He reported poor healing and the presence of a persistent ulcer since the injury….
Ultrasound Provides Insights into Immune Checkpoint Inhibitor‐Induced Inflammatory Arthritis
Ultrasound may provide unique insights into the effects of immune checkpoint inhibitors on the human body beyond the immune system. Research suggests synovitis and inflammatory tendon involvement are commonly seen in patients with immune checkpoint inhibitor-induced inflammatory arthritis.
Recurrent Medial Elbow Pain Following Successful Tommy John Surgery
A 27-year-old, left-handed man was referred to our ultrasound clinic for left elbow pain. History The patient had been a pitcher on a Minor League Baseball team. Two years before, he developed sudden, severe medial elbow pain while pitching in a game. The pain was associated with some tingling down the left medial forearm. The…
Ultrasound in Rheumatology—Past, Present & Future
For most rheumatologists, the key elements of the physical exam—inspection, palpation, percussion and auscultation—have long been second nature, but a fifth modality has grown in importance with respect to making the correct diagnosis: ultrasound. From evaluating for Doppler signal and additional findings indicative of synovitis to identifying bony erosions, chondrocalcinosis, tophi and other articular and…
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