Patient Positioning
Patient seated in front of the examiner, hand palm up resting on a examination table.
Probe Positioning
Place the transducer on a longitudinal planes over the joints and tendons of interest. Do not use any pressure – especially while looking for effusion or using doppler mode. Use dynamic scanning to check the movement of the tendons during flexion / extension or against resistance to check the pulleys.
note: periarticular and articular inflammation, erosions and subluxation of a mcp joint in a patient with psoriatic arthritis
note: enthesitis of the extensor tendon with positive dopplersignal, hypoechoic swelling of the tendon closed to its enthesis, small enthesophyte / calcification
note: typical in PsA is the periarticular inflammation – see the strong doppler signal in the soft tissue around the proximal interphalangeal joint.
note: active proliferative and exsudative tenosynovitis of the flexor tendons
pij: proximal interphalangeal joint
dij: distal interphalangeal joint
e: effusion
Note: Dactylitis with tenosynovitis, effusion pij and subcutaneous edema in a patient with psoriatic arthritis
note: articular, periarticular inflammation, calcification of the tendon, tendinitis, subcutanous edema and hyperemia in a patient with psoriatic arthritis
note: the extensor tendon shows hypoechoic swelling (tendinitis) and hypechoic swelling at the level of the enthesis with doppler signal
note: hyperemia of the soft tissue in a patient with PsA in comparison to the healthy finger.
note: calcifications in a patient with psoriatic arthritis (joint, capsule and ligaments).