Systemic lupus erythematosus arthropathy: the sonographic perspective

Area of Science:

• Rheumatology
• Radiology
• Medical Imaging

Background:

• Ultrasound (US) shows promise for assessing musculoskeletal manifestations in systemic lupus erythematosus (SLE).
• Limited literature exists on US findings in SLE, with an unclear spectrum and clinical relevance of abnormalities.
• This study addresses the need to explore joint and tendon US findings in SLE patients.

Purpose of the Study:

• To investigate the range of joint and tendon ultrasound abnormalities in patients with systemic lupus erythematosus (SLE).
• To characterize the prevalence and types of US findings in SLE-related musculoskeletal symptoms.

Main Methods:

• Twenty-five consecutive SLE patients with musculoskeletal symptoms underwent clinical examination and targeted ultrasound (US) evaluation.
• US examination focused on clinically involved or painful sites, including joints, tendons, and entheses.
• Data collected included various US parameters such as synovial effusion, hypertrophy, erosions, tenosynovitis, and entheseal changes.

Main Results:

• All 25 SLE patients exhibited one or more US abnormalities.
• US abnormalities were found in 35% of scanned joints, 32.6% of tendons, and 24.4% of entheses.
• A wide array of findings were observed, including synovial changes, erosions, cartilage damage, tenosynovitis, tendon abnormalities, and entheseal alterations (e.g., power Doppler, hypoechogenicity, enthesophytes).

Conclusions:

• Ultrasound demonstrated a broad and heterogeneous spectrum of pathological findings in the joints and tendons of SLE patients.
• US identified changes in structures not previously emphasized, such as entheses and tendons without synovial sheaths.
• These preliminary findings suggest US can detect distinct patterns in SLE, warranting further research into their clinical, prognostic, and pathogenetic significance.