Diagnostic ultrasound ( PDFDrive )

868 PART III Small Parts, Carotid Artery, and Peripheral Vessel Sonography
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FIG. 23.23 Bone Erosions in Two Different Patients Rheumatoid Arthritis. (A) Long-axis gray-scale image at the ifth metatarsophalangeal
joint demonstrates bone erosion in the ifth metatarsal head (arrow) with associated cortical irregularity and synovial hypertrophy (arrowheads). M,
Metatarsal, P, proximal phalanx. (B) Color Doppler imaging of the dorsal wrist in long-axis view demonstrates hyperemia within the synovium and
erosion (arrow) of the scaphoid (S). R, Distal radius, T, trapezium.
FIG. 23.24 Achilles Tendon With Rheumatoid Nodules. Long-axis image of the Achilles tendon demonstrates hypoechoic nodular thickening
(*) of the posterior tendon surface, consistent with rheumatoid nodules. No hyperemia was seen on color Doppler imaging (not shown).
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FIG. 23.25 Gout in Two Different Patients. (A) Long-axis gray-scale image of the irst metatarsal phalangeal joint demonstrates the “sugar
icing” appearance where echogenic urate crystals are deposited along the synovial lining of the joint (arrowheads). The “double contour sign”
is formed by the echogenic urate crystals (“sugar icing”) layering on the anechoic hyaline cartilage with the underlying echogenic cortex (arrows).
(B) Long-axis gray-scale image of the ifth metatarsal phalangeal joint shows a large erosion (arrow) with a large amorphous tophus (arrowheads),
part of which extends into the erosion. M, First metatarsal, P, irst proximal phalanx.