Clinical History
16 year old female with new onset wrist pain without recent trauma.
Diagnosis: Inflammatory Arthritis
Inflammatory arthritis, such as rheumatoid arthritis and juvenile idiopathic arthritis, is an autoimmune disorder resulting in inflammation of joints and tendons.
The various inflammatory arthritides differ in the typical age of presentation, distribution of joints involved, and serum markers.
Imaging plays an important role in the diagnosis of and monitoring of inflammatory arthritides.
Radiography, MRI, and ultrasound are all useful in the imaging of patients with an inflammatory arthritis.
On ultrasound, the hallmark of inflammatory arthritis is erosions, synovitis, and tenosynovitis.
Synovitis on ultrasound is seen as combination of joint effusion, synovial proliferation, and hyperemia.
Tenosynovitis on ultrasound is seen as fluid in and thickening of the tendon sheaths around tendons.
Hyperemia, seen as increased vascularity on power or color Doppler, is specific for active inflammation.