Systemic lupus erythematosus ultrasound or echocardiography

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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 echocardiography, SLE may present with decreased 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 Preview
Gastrointestinal
Adapted from Radiopaedia
Adapted from Radiopaedia
Renal
  • Generally hyperechoic kidneys
  • Loss of corticomedullary differentiation
  • The size of the kidneys vary depending on the duration of the involvement
Pulmonary
Adapted from Radiopaedia
Joints
  • Synovial proliferation
  • Synovial effusions and subclinical synovitis
  • Usually no erosions (the difference between SLE and RA)
  • Tenosynovitis
    • Global thickening with effusion in the sheath of tendon
Adapted from Radiopaedia
Raynaud phenomenon

Echocardiography

The main echocardiographic findings according to lupus more common cardiac involvements are:[6][7]

Adapted from Radiopaedia

Refrences

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. 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.