Systemic lupus erythematosus ultrasound or echocardiography: Difference between revisions
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! style="background: #4479BA; color: #FFFFFF; " |Organ | ! style="background: #4479BA; color: #FFFFFF; " |Organ | ||
! style="background: #4479BA; color: #FFFFFF; " |Sonography findings | ! style="background: #4479BA; color: #FFFFFF; " |Sonography findings | ||
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| style="background: #DCDCDC; " |Gastrointestinal | | style="background: #DCDCDC; " |Gastrointestinal | ||
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**Positive murphy sign | **Positive murphy sign | ||
**[[Gallbladder]] distension | **[[Gallbladder]] distension | ||
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| style="background: #DCDCDC; " |Renal | | style="background: #DCDCDC; " |Renal | ||
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* The size of the [[kidneys]] vary depending on the duration of the involvement | * The size of the [[kidneys]] vary depending on the duration of the involvement | ||
** Small and diffusely echogenic kidneys mostly on SLE-related [[chronic renal failure]] | ** Small and diffusely echogenic kidneys mostly on SLE-related [[chronic renal failure]] | ||
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| style="background: #DCDCDC; " |Pulmonary | | style="background: #DCDCDC; " |Pulmonary | ||
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* [[Pleural effusion]] | * [[Pleural effusion]] | ||
** Echo-free space between the [[Visceral pleura|visceral]] and [[parietal pleura]] | ** Echo-free space between the [[Visceral pleura|visceral]] and [[parietal pleura]] | ||
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| style="background: #DCDCDC; " |Joints | | style="background: #DCDCDC; " |Joints | ||
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* [[Synovial]] effusions and subclinical [[synovitis]] | * [[Synovial]] effusions and subclinical [[synovitis]] | ||
* Usually no erosions (the difference between SLE and [[RA]]) | * Usually no erosions (the difference between SLE and [[RA]]) | ||
* Tenosynovitis | |||
** Global thickening with effusion in the sheath of tendon | |||
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| style="background: #DCDCDC; " |[[Raynaud phenomenon]] | | style="background: #DCDCDC; " |[[Raynaud phenomenon]] | ||
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* [[Doppler sonography]] | * [[Doppler sonography]] | ||
** In the presence of [[raynaud phenomenon]], may show flow volume and vessel size irregularities | ** In the presence of [[raynaud phenomenon]], may show flow volume and vessel size irregularities | ||
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* [[Pericardial effusion]] | * [[Pericardial effusion]] | ||
** [[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 | ** [[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 | ||
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==Refrences== | ==Refrences== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 15:30, 1 August 2017
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Systemic lupus erythematosus Microchapters |
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Differentiating Systemic lupus erythematosus from other Diseases |
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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, ascites, hyperecho-kidney tissue due to nephritis, and rarely cholecystitis. On synovial ultrasound, SLE may present with synovial effusions and synovitis. On SLE may present with decrease ejection fraction, cardiac wall motion abnormality, effusion pericarditis, and valve leaflet thickening.
Ultrasound
Ultrasound can be used for the diagnosis of systemic lupus erythematosus complications. It can also be used for screening and monitoring the disease activity during pregnancy.[1] The table below presents the main ultrasound findings regarding the organ system involvement in SLE:[2][3][4][5]
| Organ | Sonography findings | |
|---|---|---|
| Gastrointestinal |
|
File:3fc11253ba09067fb09f32399ba387 big gallery.jpgFile:Acute-acalculous-cholecystitis-1.jpg |
| Renal |
|
|
| Pulmonary |
|
File:Subpulmonic effusion on ultrasonography.jpg |
| Joints |
File:Extensor-carpi-ulnaris-tenosynovitis-1.jpg | |
| Raynaud phenomenon |
|
Echocardiography
The main echocardiographic findings according to lupus more common cardiac involvements are:[6][7]
- Decrease ejection fraction
- Myocarditis
- Wall motion abnormality diagnosed mostly by trans-esophageal echocardiography
- 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
- Valve thickening
- Valve regurgitation
- Pericardial effusion
- 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
- = File:5e2515ac54c842fffa820c85e60acd big gallery.jpeg =
Refrences
- ↑ Giancotti A, Spagnuolo A, Bisogni F, D'Ambrosio V, Pasquali G, Panici PB (2011). "Pregnancy and systemic lupus erythematosus: role of ultrasound monitoring". Eur. J. Obstet. Gynecol. Reprod. Biol. 154 (2): 233–4. doi:10.1016/j.ejogrb.2010.10.020. PMID 21144639.
- ↑ Lins CF, Santiago MB (2015). "Ultrasound evaluation of joints in systemic lupus erythematosus: a systematic review". Eur Radiol. 25 (9): 2688–92. doi:10.1007/s00330-015-3670-y. PMID 25716942.
- ↑ 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.
- ↑ 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.
- ↑ Iagnocco A, Ceccarelli F, Rizzo C, Truglia S, Massaro L, Spinelli FR, Vavala C, Valesini G, Conti F (2014). "Ultrasound evaluation of hand, wrist and foot joint synovitis in systemic lupus erythematosus". Rheumatology (Oxford). 53 (3): 465–72. doi:10.1093/rheumatology/ket376. PMID 24231444.
- ↑ Nihoyannopoulos P, Gomez PM, Joshi J, Loizou S, Walport MJ, Oakley CM (1990). "Cardiac abnormalities in systemic lupus erythematosus. Association with raised anticardiolipin antibodies". Circulation. 82 (2): 369–75. PMID 2372888.
- ↑ Hübbe-Tena C, Gallegos-Nava S, Márquez-Velasco R, Castillo-Martínez D, Vargas-Barrón J, Sandoval J, Amezcua-Guerra LM (2014). "Pulmonary hypertension in systemic lupus erythematosus: echocardiography-based definitions predict 6-year survival". Rheumatology (Oxford). 53 (7): 1256–63. doi:10.1093/rheumatology/keu012. PMID 24599923.