Systemic lupus erythematosus ultrasound or echocardiography

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, 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 in 2 ways: echocardiography for evaluation of cardiac complications and ultrasound in the diagnosis of abdominal muscular and synovial problems

• Synovial tissue in knee
  • Synovial proliferation
  • Synovial effusions and synovitis
  • Usually no erosions (the difference between SLE and RA)
• Abdomen
  • Hepatosplenomegaly
  • Ascitis
  • Rarely cholecystitis

• Pleuea
  • Pleural effusion with an echo-free space between the visceral and parietal pleura
• Kidneys
  • Hyperecho kidney tissue
  • Nephromegaly with an association between the size of the kidney and the duration of renal involvement
  • Small and diffusely echogenic kidneys mostly manifests chronic renal failure

Echocardiography

• Decrease ejection fraction

Myocardium

• Wall motion abnormality diagnosed mostly by trans-esophageal echocardiography mainly due to mayocarditis

Pericardium

• Effusion pericarditis

Valvular diseases

• 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 Nihoyannopoulos P, Gomez PM, Joshi J, Loizou S, Walport MJ, Oakley CM. Cardiac abnormalities in systemic lupus erythematosus: association with raised anticardiolipin antibodies. Circulation 1990; 82:369-375.
• Valve thickening
• Valve regurgitation