Scanning Technique | |
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Glenohumeral joint | Presence or absence of fluid and/or hypoechoic synovial hypertrophy in the bicipital groove, transducer transversal and longitudinal to the anterior part of the humerus, shoulder in neutral position. Axillary recess, longitudinal scan |
Elbow | Transverse anterior scan and posterior scan with elbow flexed at 90°: presence or absence of fluid and/or hypoechoic synovial hypertrophy from the humeral capitellum or the coronoid fossa to the joint capsule |
Wrist | Longitudinal and transversal, from the dorsal aspect with the joint in neutral position, probe located on the 3rd finger: presence or absence of fluid and/or hypoechoic synovial hypertrophy from the bones to the joint capsule |
5 MCP and 5 PIP | Longitudinal scanning of the dorsal MCP and PIP joints in extension: presence or absence of fluid and/or hypoechoic synovial hypertrophy from the articular bony margin to the joint capsule |
Knee | Longitudinal and transversal, from the suprapatellar recess, in a supine position, with the joint in 30° of flexion: presence or absence of fluid and/or hypoechoic synovial hypertrophy in the anteroposterior diameter of the suprapatellar recess |
Scoring System | |
B-mode | Grade 0 or normal: Normal joint (no synovial hypertrophy, no joint effusion) Grade 1 or minimal: Minimal synovitis (minimal synovial hypertrophy, with or without minimal joint effusion) Grade 2 or moderate: Moderate synovitis (moderate synovial hypertrophy, with or without minimal or moderate joint effusion) Grade 3 or severe: Severe synovitis (severe synovial hypertrophy, with or without severe joint effusion) |
Power Doppler | Grade 0: no vessel in the synovium Grade 1: up to 3 discrete spots or 1 confluent spot plus up to 2 discrete spots Grade 2: vessel signals in less than 50% of the surface area of the synovium Grade 3: vessel signals in more than 50% of the surface area of the synovium |
MCP: metacarpophalangeal; PIP: proximal interphalangeal.