Ann Rheum Dis 58:595-597 doi:10.1136/ard.58.10.595
  • Now and then

Synovitis of small joints: sonographic guided diagnostic and therapeutic approach

  1. Walter Grassi,
  2. Gianni Lamanna,
  3. Antonella Farina,
  4. Claudio Cervini
  1. Department of Rheumatology, University of Ancona, Italy
  1. Dr W Grassi, Clinica Reumatologica, Università degli Studi di Ancona, Ospedale A Murri, Via dei Colli, 52, I-60035 Jesi (Ancona), Italy.
  • Accepted 12 March 1999


OBJECTIVE The aim of this pictorial essay is to describe the sonographic guided approach to investigation and local injection therapy of a small joint in a patient with psoriatic arthritis (PA).

METHODS Sonographic pictures are obtained using a high frequency ultrasonography apparatus equipped with a 13-MHz transducer.

RESULTS Ultrasonography allows a careful morphostructural assessment of soft tissue involvement in PA patients. Sonographic findings include joint cavity widening, capsular thickening, synovial proliferation, synovial fluid changes, tendon sheath widening. Ultrasound guided placement of the needle within the joint and injection of corticosteroid under sonographic control can be easily performed.

CONCLUSIONS High frequency ultrasonography is a quick and safe procedure that allows a useful diagnostic and therapeutic approach in patients with arthritis of small joints.