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==Ultrasound==
==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 muscular and synovial problems
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 muscular and synovial problems
* Synovial tissue in knee
** Synovial proliferation
** Synovial effusions and synovitis
** Usually no erosions (the difference between SLE and RA)<ref name="pmid19473577">{{cite journal |vauthors=Ossandon A, Iagnocco A, Alessandri C, Priori R, Conti F, Valesini G |title=Ultrasonographic depiction of knee joint alterations in systemic lupus erythematosus |journal=Clin. Exp. Rheumatol. |volume=27 |issue=2 |pages=329–32 |year=2009 |pmid=19473577 |doi= |url=}}</ref>
* Abdomen
** Hepatosplenomegaly
** Ascitis
** Rarely cholecystitis


* Pleuea
{| class="wikitable"
** Pleural effusion with an echo-free space between the visceral and parietal pleura<ref name="pmid22934226">{{cite journal |vauthors=Virdi RP, Bashir A, Shahzad G, Iqbal J, Mejia JO |title=Diffuse alveolar hemorrhage: a rare life-threatening condition in systemic lupus erythematosus |journal=Case Rep Pulmonol |volume=2012 |issue= |pages=836017 |year=2012 |pmid=22934226 |pmc=3420594 |doi=10.1155/2012/836017 |url=}}</ref>
!Organ
* Kidneys
!Sonography findings
** Hyperecho kidney tissue
|-
** Nephromegaly with an association between the size of the kidney and the duration of renal involvement
|Gastrointestinal system
** Small and diffusely echogenic kidneys mostly manifests chronic renal failure
|
*General
**Free fluid in the abdomen suggestive of ascitis
*Liver
**Hepatomegaly
**Hepatic steatosis
*Pancreas
**Hypoechoic necrosis regions
**May accompany vascular complications, e.g. thrombosis
*Spleen
**Splenomegaly
**In cases of autosplenectomy, ultrasound will either not be able to demonstrate a spleen at all, or identify a small irregular and shadowing nodule in the splenic bed
*Cholecystitis
**Gallbladder wall thickening (>3 mm) and pericholecystic fluid
**Positive Murphy sign
**gallbladder distension
|-
|Pulmonary system<ref name="pmid22934226">{{cite journal |vauthors=Virdi RP, Bashir A, Shahzad G, Iqbal J, Mejia JO |title=Diffuse alveolar hemorrhage: a rare life-threatening condition in systemic lupus erythematosus |journal=Case Rep Pulmonol |volume=2012 |issue= |pages=836017 |year=2012 |pmid=22934226 |pmc=3420594 |doi=10.1155/2012/836017 |url=}}</ref>
|
* [[Pleural effusion]]
** Echo-free space between the visceral and parietal pleura
|-
|Joints<ref name="pmid19473577">{{cite journal |vauthors=Ossandon A, Iagnocco A, Alessandri C, Priori R, Conti F, Valesini G |title=Ultrasonographic depiction of knee joint alterations in systemic lupus erythematosus |journal=Clin. Exp. Rheumatol. |volume=27 |issue=2 |pages=329–32 |year=2009 |pmid=19473577 |doi= |url=}}</ref>
|
* Synovial proliferation
* Synovial effusions and synovitis
* Usually no erosions (the difference between SLE and RA)
|-
|Raynaud phenomen
|
* Doppler sonography:
** In the presence of raynaud phenomen, may show flow volume and vessel size irregularities
|}


=== Echocardiography ===
== Echocardiography ==
* Decrease ejection fraction
* Decrease [[ejection fraction]]
 
* [[Myocarditis]]
===== Myocardium =====
** Wall motion abnormality diagnosed mostly by trans-esophageal [[echocardiography]]
* Wall motion abnormality diagnosed mostly by trans-esophageal echocardiography mainly due to mayocarditis
* [[Valvular abnormalities]]
 
** 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 2372888
==== Pericardium ====
** Valve thickening
* Effusion pericarditis
** Valve regurgitation
 
* [[Pericardial effusion]]
===== Valvular diseases =====
** [[Echocardiography]] is the method of choice to confirm the diagnosis, estimate the volume of fluid and most importantly assess the haemodynamic impact of the effusion
* 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


==Refrences==
==Refrences==
{{reflist|2}}
{{reflist|2}}

Revision as of 17:53, 17 July 2017

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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]

Overview

On abdominal ultrasound, systemic lupus erythematosus (SLE) may present with hepatosplenomegaly, ascitis, hyperecho kidney tissue, and rarely cholecystitis. On synovial ultrasound, SLE may present with synovial effusions and synovitis. On SLE may present with decrease ejection fraction, wall motion abnormality, effusion pericarditis, and valve leaflet thickening.

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 muscular and synovial problems

Organ Sonography findings
Gastrointestinal system
  • General
    • Free fluid in the abdomen suggestive of ascitis
  • Liver
    • Hepatomegaly
    • Hepatic steatosis
  • Pancreas
    • Hypoechoic necrosis regions
    • May accompany vascular complications, e.g. thrombosis
  • Spleen
    • Splenomegaly
    • In cases of autosplenectomy, ultrasound will either not be able to demonstrate a spleen at all, or identify a small irregular and shadowing nodule in the splenic bed
  • Cholecystitis
    • Gallbladder wall thickening (>3 mm) and pericholecystic fluid
    • Positive Murphy sign
    • gallbladder distension
Pulmonary system[1]
Joints[2]
  • Synovial proliferation
  • Synovial effusions and synovitis
  • Usually no erosions (the difference between SLE and RA)
Raynaud phenomen
  • Doppler sonography:
    • In the presence of raynaud phenomen, may show flow volume and vessel size irregularities

Echocardiography

Refrences

  1. Virdi RP, Bashir A, Shahzad G, Iqbal J, Mejia JO (2012). "Diffuse alveolar hemorrhage: a rare life-threatening condition in systemic lupus erythematosus". Case Rep Pulmonol. 2012: 836017. doi:10.1155/2012/836017. PMC 3420594. PMID 22934226.
  2. Ossandon A, Iagnocco A, Alessandri C, Priori R, Conti F, Valesini G (2009). "Ultrasonographic depiction of knee joint alterations in systemic lupus erythematosus". Clin. Exp. Rheumatol. 27 (2): 329–32. PMID 19473577.