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Intermetacarpal Osteoarthritis

Osteoarthritis. Index finger of the dominant hand. Dorsal longitudinal views.a Distal interphalangeal joint.b Proximal inter-phalangeal joint. c Metacarpophalangeal joint. dp = distal phalanx; mp = middle phalanx; pp = proximal phalanx; m = metacarpal bone; t = extensor tendon; arrowhead = osteophyte

Osteoarthritis. Supra-patellar longitudinal US scan showing widening of the supra-patellar pouch due to synovial fluid (*) and proliferation (+). f = femur; p = upper pole of the patella; t = quadriceps tendon

Longitudinal Popliteal Space

Osteoarthritis of the knee. Different US features of popliteal cysts. a Anechoic with floating echogenic spots. b Areas of synovial proliferation. c Septa and areas of synovial proliferation.d Completely filled by synovial proliferation

Synovial Cyst Popliteal Space

Osteoarthritis of the knee. Lateral longitudinal views of the suprapatellar pouch showing different aspects of synovial proliferation (arrowheads). f = femur

Osteoarthritis of the knee. Lateral longitudinal views of the suprapatellar pouch showing different aspects of synovial proliferation (arrowheads). f = femur

Fine particulate debris floating in the synovial fluid is generally observed after long-standing or repeated joint effusions or after intra-articular cor-ticosteroid administration.

In patients with asymptomatic Heberden's nodes, there is usually no detectable joint space widening. Conversely, symptomatic joint involvement is frequently associated with variable capsular distension (Fig. 5.8 a,b).

Popliteal cysts are a frequent finding in patients with knee osteoarthritis (Fig. 5.6 a-d). US provides structural details about the content of the cyst, its communication with the joint space and possible compression of adjacent vascular structures. Both the size and shape of cysts vary widely, ranging from small (<1 cm) to giant, multi-loc-ulated entities.

Synovial proliferation

Synovial proliferation in osteoarthritis may display US features similar to those observed in patients with chronic inflammatory arthritis but without the invasive properties of rheumatoid pannus (Fig. 5.7 a, b). Thickened, edematous synovium is frequently observed in more severe disease and in patients with recurrent effusions.

Osteophytes

Osteophytes are easily detected as irregularities of the bone contour. The skyline view of an osteoarthritic joint is characteristic and correlates with conventional radiographic changes (Fig. 5.9 a,b).

Heberden's nodes. Longitudinal dorsal US scan.a Symptomatic joint. Dorsal subluxation of the distal phalanx with no evidence of joint inflammation. b Symptomatic joint. Joint effusion (*) and osteophytes (arrowheads). dp = distal phalanx; mp = middle phalanx; t = extensor tendon; arrowhead = osteophyte

Osteophytes in knee osteoarthritis.a Conventional radiography. b Medial longitudinal US scan showing an osteophyte of the femoral condyle (arrowhead). f = femur; t = tibia

Heberden's nodes. Longitudinal dorsal US scan.a Symptomatic joint. Dorsal subluxation of the distal phalanx with no evidence of joint inflammation. b Symptomatic joint. Joint effusion (*) and osteophytes (arrowheads). dp = distal phalanx; mp = middle phalanx; t = extensor tendon; arrowhead = osteophyte

Osteophytes in knee osteoarthritis.a Conventional radiography. b Medial longitudinal US scan showing an osteophyte of the femoral condyle (arrowhead). f = femur; t = tibia

Erosive osteoarthritis

Sonographic findings in patients with erosive osteoarthritis usually combine the aspects of both osteoarthritis (osteophytes and subluxation of the articular surfaces) and inflammatory involvement (joint space widening and intra-articular power Doppler signal) (Fig. 5.10 a,b) [19,20].

Neck Regions Ultrasound

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