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Logo of annrheumdAnnals of the Rheumatic DiseasesCurrent TOCInstructions for authors
 
Ann Rheum Dis. Feb 2001; 60(2): 98–103.
PMCID: PMC1753465
Ultrasonography in the evaluation of bone erosions
W Grassi, E Filippucci, A Farina, F Salaffi, and C Cervini
Department of Rheumatology, University of Ancona, Italy. reuman/at/popcsi.unian.it
OBJECTIVE—To demonstrate the diagnostic efficacy of ultrasonography in depicting erosions in patients with rheumatoid arthritis and to compare sonographic and radiographic findings.
METHODS—Sonographic images were obtained with an AU-4 Idea Esaote Biomedica (Genoa, Italy) equipped with a 13 MHz linear transducer.
RESULTS—The images reported in this essay are representative examples of the ability of ultrasonography to detect and characterise even minimal bone margin changes in rheumatoid arthritis.
CONCLUSION—Ultrasonography with very high frequency transducers can depict bone erosions in early target areas of bone resorption. However, further studies are needed to validate this technique and to evaluate the relation between sonographic findings and those obtained with other imaging techniques (standard radiology, magnetic resonance).

Figure 1
Figure 1  
Healthy subject. Metacarpophalangeal joint of the second finger: longitudinal (A) and transverse (B) dorsal scans. Metatarsophalangeal joint of the fifth toe: longitudinal (C) and transverse (D) dorsal scans. Articular cartilage appears as a clearly (more ...)
Figure 2
Figure 2  
Rheumatoid arthritis. Longitudinal dorsal scans. Sonographic features of bone erosions of the metacarpal head. (A and B) Early disease. (C and D) Late disease. * = erosion; mc = metacarpal head; ph = phalanx. (more ...)
Figure 3
Figure 3  
Rheumatoid arthritis. Longitudinal dorsal views at different scanning planes as indicated on the corresponding standard radiogram (A). (B) Longitudinal dorsal scan shows a still well defined bone margin of the metacarpal head. (C) Longitudinal dorsal (more ...)
Figure 4
Figure 4  
Rheumatoid arthritis. Metacarpophalangeal joint of the second finger (same patient as fig 3). (A) Coronal scan. (B) Healthy subject. The coronal view demonstrates the good correspondence between radiographic (C) and sonographic (D) changes of the bone (more ...)
Figure 5
Figure 5  
Rheumatoid arthritis. Metatarsal head of the fifth toe. Standard x ray (A) does not reveal clearly evident erosive changes (Sharp's score =1). (B and C) Off line digitalised radiograms show two areas of lower bone density (*) and loss of the normal sharp (more ...)
Figure 6
Figure 6  
Rheumatoid arthritis. Metatarsophalangeal joint of the fifth toe. Sonographic features of the metatarsal head at different scanning planes. These pictures demonstrate the potential role of multiplanar sonographic examination in detecting bone erosion (more ...)
Figure 7
Figure 7  
Rheumatoid arthritis. Metatarsophalangeal joint of the fifth toe. Sonographic findings in late rheumatoid arthritis with cystic like areas of bone resorption on posteroanterior view. (A) Standard x ray. (B) Longitudinal dorsal scan between the two areas (more ...)
Figure 8
Figure 8  
Rheumatoid arthritis. Metacarpophalangeal joint of the second finger. (A) Standard x ray. Multiplanar examination in patient with late disease. Ultrasonography is able to depict the extent of bone resorption both on longitudinal (B and C) and transverse (more ...)
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