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

Organ	Sonography findings
Gastrointestinal system	General Free fluid in the abdomen suggestive of ascitis Liver Hepatomegaly Hepatic steatosis Pancreas Hypoechoic necrosis regions May accompany vascular complications, e.g. thrombosis Spleen 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 Cholecystitis Gallbladder wall thickening (>3 mm) and pericholecystic fluid Positive Murphy sign gallbladder distension
Pulmonary system	Pleural effusion Echo-free space between the visceral and parietal pleura
Joints	Synovial proliferation Synovial effusions and synovitis Usually no erosions (the difference between SLE and RA)
Raynaud phenomen	Doppler sonography: In the presence of raynaud phenomen, may show flow volume and vessel size irregularities

Echocardiography

• 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