Systemic lupus erythematosus ultrasound or echocardiography

Systemic lupus erythematosus Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]

Ultrasound

Ultrasound can be used for the diagnosis of systemic lupus erythematosus complications in 2 ways: echocardiography for evaluation of cardiac complications and ultrasound in the diagnosis of abdominal/ musculotendinus problems

Ultrasonography of synovial tissue in knee may show synovial proliferation and effusions. Ultrasound may also shows synovitis but there is usually no erosions (the difference between SLE and RA).

Pleura

Pleural effusion: echo-free space between the visceral and parietal pleura

Schwab EP, Schumacher HR, Jr, Freundlich B, Callegari PE. Pulmonary alveolar hemorrhage in systemic lupus erythematosus. Semin Arthritis Rheum 1993; 23:8-15.

Nephritis manifestations

• Hyperechoic kidneys
  • The size of the kidney depends on the duration of renal involvement
  • Small and diffusely echogenic kidneys mostly manifests chronic renal failure due to SLE

Echocardiography

• Decrease ejection fraction

Myocardium

• Wall motion abnormality diagnosed mostly by trans-esophageal echocardiography mainly due to mayocarditis

Pericardium

• Effusion pericarditis

Valvular diseases

• Valve leaflet thickening due to Libman-Sacks endocarditis characterized by the formation of small single or multiple, sterile, granular pink vegetations ranging from 1 to 4 mm Nihoyannopoulos P, Gomez PM, Joshi J, Loizou S, Walport MJ, Oakley CM. Cardiac abnormalities in systemic lupus erythematosus: association with raised anticardiolipin antibodies. Circulation 1990; 82:369-375.
• Valve thickening
• Valve regurgitation