Systemic lupus erythematosus ultrasound or echocardiography: Difference between revisions
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==Ultrasound== | ==Ultrasound== | ||
Ultrasound can be used for the diagnosis of systemic lupus erythematosus complications in | Ultrasound can be used for the diagnosis of systemic lupus erythematosus complications. The table below presents the main ultrasound findings regarding the organ system involvement in SLE: | ||
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*General | *General | ||
**Free fluid in the abdomen suggestive of | **Free fluid in the abdomen suggestive of [[ascites]] | ||
*Liver | *Liver | ||
**Hepatomegaly | **[[Hepatomegaly]] | ||
**Hepatic steatosis | **[[Hepatic steatosis]] | ||
*Pancreas | *Pancreas | ||
**Hypoechoic necrosis regions | **Hypoechoic [[necrosis]] regions | ||
**May accompany vascular complications, e.g. thrombosis | **May accompany vascular complications, e.g. [[thrombosis]] | ||
*Spleen | *Spleen | ||
**Splenomegaly | **[[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 | **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 | *[[Cholecystitis]] | ||
**Gallbladder wall thickening (>3 mm) and pericholecystic fluid | **Gallbladder wall thickening (>3 mm) and pericholecystic fluid | ||
**Positive | **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> | |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]] | * [[Pleural effusion]] | ||
** Echo-free space between the visceral and parietal pleura | ** 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> | |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> | ||
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* Synovial proliferation | * Synovial proliferation | ||
* Synovial effusions and synovitis | * Synovial effusions and [[synovitis]] | ||
* Usually no erosions (the difference between SLE and RA) | * Usually no erosions (the difference between SLE and [[RA]]) | ||
|- | |- | ||
|Raynaud | |Raynaud phenomenon | ||
| | | | ||
* Doppler sonography | * [[Doppler sonography]] | ||
** In the presence of raynaud | ** In the presence of [[raynaud phenomenon]], may show flow volume and vessel size irregularities | ||
|} | |} | ||
Revision as of 18:41, 17 July 2017
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Systemic lupus erythematosus Microchapters |
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Differentiating Systemic lupus erythematosus from other Diseases |
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Systemic lupus erythematosus ultrasound or echocardiography On the Web |
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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. The table below presents the main ultrasound findings regarding the organ system involvement in SLE:
| Organ | Sonography findings |
|---|---|
| Gastrointestinal system |
|
| Pulmonary system[1] |
|
| Joints[2] | |
| Raynaud phenomenon |
|
Echocardiography
The main echocardiographic findings according to lupus more common cardiac involvements are[3]:
- 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
Refrences
- ↑ 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.
- ↑ 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.