Jump to comment:

• Ultrasonographic bone changes are really two stages {types}
  Mahamoud M Gabal
  Published on: 10 October 2006

• Published on: 10 October 2006

  Ultrasonographic bone changes are really two stages {types}

  • Mahamoud M Gabal, Radiologist

  Dear Editor, I read with interest this work. Indeed ultrasonography has increasing role in this field so the interpretation of its images is so important for the rheumatologist. From a radiological and pathological point of view we can divide the changes of the bone in this disease into two types. Type one, which is the pre-erosive stage appears as many hyperechoic bone islands in the ostoid tissue of the cortical and en...

  Show More

  Dear Editor, I read with interest this work. Indeed ultrasonography has increasing role in this field so the interpretation of its images is so important for the rheumatologist. From a radiological and pathological point of view we can divide the changes of the bone in this disease into two types. Type one, which is the pre-erosive stage appears as many hyperechoic bone islands in the ostoid tissue of the cortical and endocortical parts associated with multiple black areas which lost its normal mineralization. This can be seen in most of the figures, like figure 2{C and D ], figure 3 … The second type with punched out cortical areas that denote severe changes and real ostoid loss like figure 4d. Figure 8 show both of the two types. Figure 8 shows also that the hypodense areas detected by plain X-ray may correspond either to type one or type two at ultrasound examination. The presence of this speckled bone islands in type one is a good indicator of the ostoid presence. This could be used as a predictor of the future healing on the course of treatment. Neither the plain X-ray nor the MRI can differentiate type one from type two. So ultrasound can detect two stages - first = the stage of bone deminieralization with scattered hyperechoic bone islands {type one or pre-erosive stage} denoting presense of ostoid bone - second the stage of the real bone erosion with no or minimally present ostoid tissue {type two ore the erosive stage }. This will help certainly in prediction of out come of treatment ...

  Show Less

  Conflict of Interest:
  None declared.

  • Back to top