RESEARCH - Ultrasonography for assessment of subcutaneous nodules

[Guest guest]

J Rheumatol. 2003 Jun;30(6):1191-5.

Ultrasonography for assessment of subcutaneous nodules.

Nalbant S, Corominas H, Hsu B, Chen LX, Schumacher HR, Kitumnuaypong T.

Rheumatology Division of the Hospital of the University of Pennsylvania,

Philadelphia, USA.

OBJECTIVE: To characterize a variety of subcutaneous lesions by their

ultrasonographic (US) appearance, and establish these images as a

starting point to measure changes with treatments. METHODS: Twenty-six

patients with 48 subcutaneous nodular swellings of various types were

imaged using a portable US machine equipped with a 10 MHz linear

transducer. All patients had a known diagnosis of a rheumatic disease.

We used US to examine subcutaneous lesions and the underlying cortical

surface of the bone or joint. Two measurements of some tophi and

rheumatoid nodules were done on different dates to examine

reproducibility of the measurements. RESULTS: Nodular lesions included

20 tophi and 20 rheumatoid nodules, 2 sarcoid nodules, 2 lipomas, and 4

synovial cysts. Tophi most often appeared as heterogeneous masses;

hypoechoic areas in 2 tophi were decreased after aspiration of chalky

liquid tophaceous material. Occasionally tophi had calcifications

appearing hyperechoic with acoustic shadowing. Cortical bone erosions

could be seen adjacent to some tophi. The nodules in patients with

rheumatoid arthritis were often attached closely to the bone surface and

less erosive to bone, allowing the cortical bone to be seen easily. The

nodules were more homogeneous. Some showed a central sharply demarcated

hypoechoic area, possibly corresponding to necrosis inside the

rheumatoid nodules. Nodules were easily measured. The repeated

measurements of both tophi and rheumatoid nodules showed excellent

reproducibility. Lipomas had different echogenic patterns depending on

composition of the associated connective tissue and position of the

mass. They could be hypoechogenic, hyperechogenic, or mixed, but were

easily distinguished by oval shapes with well demarcated capsules.

Synovial cysts seen in this study had a characteristic hypoechoic

pattern.

CONCLUSION: Subcutaneous nodules examined by sonography show

characteristics and patterns that, although not diagnostic, can be used

to help distinguish their etiology. Tophi and rheumatoid nodules can be

easily measured and these measurements used to help follow disease

progression or response to therapy.

PMID: 12784388

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[Guest guest]

This was an interesting article. I didn't know that nodules could

disappear with treatment, but the nodules on my elbows are just about

completely gone.

Sue

On Saturday, November 20, 2004, at 09:09 PM, wrote:

>

> CONCLUSION: Subcutaneous nodules examined by sonography show

> characteristics and patterns that, although not diagnostic, can be used

> to help distinguish their etiology. Tophi and rheumatoid nodules can be

> easily measured and these measurements used to help follow disease

> progression or response to therapy.

[Guest guest]

This was an interesting article. I didn't know that nodules could

disappear with treatment, but the nodules on my elbows are just about

completely gone.

Sue

On Saturday, November 20, 2004, at 09:09 PM, wrote:

>

> CONCLUSION: Subcutaneous nodules examined by sonography show

> characteristics and patterns that, although not diagnostic, can be used

> to help distinguish their etiology. Tophi and rheumatoid nodules can be

> easily measured and these measurements used to help follow disease

> progression or response to therapy.