Sonographically guided procedures in rheumatology.
OBJECTIVE
To provide some representative examples of sonographically guided arthrocentesis and intralesional injection therapy.


METHODS
Sonographic evaluation was performed with high-frequency linear (13 MHz) and mechanical sector (20 MHz) transducers. The images were obtained in representative patients with rheumatoid arthritis and posttraumatic subacromial bursitis.


RESULTS
Sonographically guided intralesional injection is a rapid and reliable procedure, especially in patients with arthritis, tenosynovitis, and bursitis. After target localization, needle placement can be performed under continuous sonographic monitoring. Sonographic guidance is particularly useful when fluid collections are small (less than 5 mm) and deep or when the inflammatory process is adjacent to anatomic structures that could be seriously damaged by the injection.


CONCLUSIONS
Over the last few years, the rapid technologic advancements in ultrasonography have dramatically increased the potential applications of sonographically guided procedures. The simplicity and reliability of the technique might warrant rheumatologists to undergo sonographic training.
Grassi
W
W
Department of Rheumatology, University of Ancona, Italy. reuman@popcsiunian.it
Farina
A
A
Filippucci
E
E
Cervini
C
C
D001182:Arthroscopy / Q000379:methods*; D002062:Bursitis / Q000628:therapy; D003560:Cysts / Q000628:therapy; D006801:Humans; D015552:Injections, Intralesional / Q000379:methods; D007596:Joints / Q000000981:diagnostic imaging; D017410:Practice Guidelines as Topic; D012219:Rheumatology; D013717:Tenosynovitis / Q000628:therapy; D014464:Ultrasonic Therapy / Q000379:methods*; D014463:Ultrasonography