title: Remitting seronegative symmetrical synovitis with pitting edema of the hands: ultrasound, color doppler ultrasound, and magnetic resonance imaging findings.
abstract: OBJECTIVE
  To assess the value of gray-scale ultrasound (US), color Doppler ultrasound (CDUS), contrast-enhanced CDUS, and magnetic resonance imaging (MRI) in the diagnostic evaluation of the hands in patients with remitting seronegative symmetrical synovitis with pitting edema (RS3PE).
  
  
  METHODS
  Eight patients (5 men, 3 women; mean +/- SD age 69.3 +/- 7.2 years) with clinical diagnosis of RS3PE syndrome underwent US, CDUS, contrast-enhanced CDUS, and MRI. US was performed with a linear array transducer operating at 12 MHz. The US contrast agent (SHU 508; Levovist, Schering, Germany) was intravenously infused in a concentration of 300 mg/ml at a rate of 1 ml/minute.
  
  
  RESULTS
  All patients showed symmetric subcutaneous edema and synovitis of tendons and finger joints on both US and MRI. Vascularity was detected subcutaneously in tendon sheaths and in the joint synovia on CDUS and MRI. Detection of increased vascularity was improved after contrast administration compared with unenhanced CDUS (P < 0.01).
  
  
  CONCLUSIONS
  Ultrasound, CDUS, contrast-enhanced CDUS, and MRI are valuable tools in the diagnostic evaluation of involved anatomic structures in patients with RS3PE. Contrast-enhanced CDUS is superior to CDUS in assessment of inflammatory edema, effusion, and synovitis.
authors.affiliation: University Hospital Innsbruck, Austria. andrea.klauser@uibk.ac.at
authors.forename: Andrea
authors.initials: A
authors.lastname: Klauser
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Frauscher
authors.forename: Ethan J
authors.initials: EJ
authors.lastname: Halpern
authors.forename: Erich
authors.initials: E
authors.lastname: Mur
authors.forename: Peter
authors.initials: P
authors.lastname: Springer
authors.forename: Werner
authors.initials: W
authors.lastname: Judmaier
authors.forename: Michael
authors.initials: M
authors.lastname: Schirmer
mesh_terms: D000368:Aged; D001808:Blood Vessels; D003287:Contrast Media / Q000494:pharmacology; D004487:Edema / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D005260:Female; D005384:Finger Joint / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D006225:Hand / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012075:Remission, Spontaneous; D012698:Serologic Tests; D013583:Synovial Membrane / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D013717:Tenosynovitis / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D018615:Ultrasonography, Doppler, Color / Q000379:methods*
chemical_list: D003287:Contrast Media