Systemic lupus erythematosus ultrasound or echocardiography: Difference between revisions
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{| class="wikitable" | {| class="wikitable" | ||
!Organ | ! style="background: #4479BA; color: #FFFFFF; " |Organ | ||
!Sonography findings | ! style="background: #4479BA; color: #FFFFFF; " |Sonography findings | ||
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|Gastrointestinal | | style="background: #DCDCDC; " |Gastrointestinal | ||
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*General | *General | ||
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**[[Gallbladder]] distension | **[[Gallbladder]] distension | ||
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|Renal | | style="background: #DCDCDC; " |Renal | ||
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* Generally hyperechoic kidneys | * Generally hyperechoic kidneys | ||
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** 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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|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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|Joints | | style="background: #DCDCDC; " |Joints | ||
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* [[Synovial]] proliferation | * [[Synovial]] proliferation | ||
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* Usually no erosions (the difference between SLE and [[RA]]) | * Usually no erosions (the difference between SLE and [[RA]]) | ||
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|[[Raynaud phenomenon]] | | style="background: #DCDCDC; " |[[Raynaud phenomenon]] | ||
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* [[Doppler sonography]] | * [[Doppler sonography]] | ||
Revision as of 21:28, 31 July 2017
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Systemic lupus erythematosus Microchapters |
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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 |
|
| Renal |
|
| Pulmonary |
|
| Joints | |
| 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
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.