Skip to main content
SpringerLink
Log in

Ultrasound evaluation of joints in systemic lupus erythematosus: a systematic review

  • Ultrasound
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

The aim of this systematic review is to describe the scientific evidence regarding sonographic findings of joints in SLE patients.

Methods

Seven databases were searched (PubMed, ScienceDirect, Scopus, Cochrane, EMBASE, LILACS, and SciELO) for articles from 1950 to January 2015. The keywords used for selecting articles include “lupus”, “ultrasound imaging”, “ultrasonography”, “synovitis”, “tenosynovitis”, and “arthritis”.

Results

A total of 12 articles were included in the final analysis. In total, 610 SLE patients and 1,091 joints were studied. Most patients underwent bilateral joint examination by US. A total of 888 hands and wrists, 154 ankles/feet, and 56 knees were examined. Effusion was identified in 602 joints, synovitis in 213, tenosynovitis in 210, synovial hypertrophy in 150, and bone erosions in 73 cases. The majority of the studies demonstrated higher frequency of musculoskeletal abnormalities on US than those observed on physical examination.

Conclusion

US seems to be a valuable tool to identify subclinical joint manifestations in SLE. Prospective studies are necessary to determine if those patients with subclinical joint abnormalities have a higher risk for the development of chronic deformities as those seen in Jaccoud’s Arthropathy.

Key Points

• Musculoskeletal involvement occurs in more than 90 % of SLE cases.

• Arthralgia or tender/swollen joints found on physical examination showed more US findings.

• Patients without joint symptoms or physical examinations changes showed musculoskeletal sonographic findings.

• US became a useful tool for rheumatologists.

• A substantial number of asymptomatic patients show abnormalities at musculoskeletal US.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Messuti L, Zoli A, Gremese E, Ferraccioli G (2014) Joint involvement in SLE: the controversy of RHUPUS. Int Trends Immun 2(4):155–161

    Google Scholar 

  2. Santiago MB, Galvao V (2008) Jaccoud arthropathy in systemic lupus erythematosus: analysis of clinical characteristics and review of the literature. Medicine (Baltimore) 87(1):37–44

    Article  Google Scholar 

  3. Demirkaya E, Ozcakar L, Turker T et al (2009) Musculoskeletal sonography in juvenile systemic lupus erythematosus. Arthritis Rheum 61(1):58–60

    Article  PubMed  Google Scholar 

  4. Grossman JM (2009) Lupus arthritis. Best Pract Res Clin Rheumatol 23(4):495–506

    Article  PubMed  Google Scholar 

  5. Ball EM, Bell AL (2012) Lupus arthritis–do we have a clinically useful classification? Rheumatology 51(5):771–779

    Article  PubMed  Google Scholar 

  6. Kaya A, Kara M, Tiftik T et al (2013) Ultrasonographic evaluation of the femoral cartilage thickness in patients with systemic lupus erythematosus. Rheumatol Int 33(4):899–901

    Article  PubMed  Google Scholar 

  7. Kaya A, Kara M, Tiftik T (2013) Ultrasonographic evaluation of the muscle architecture in patients with systemic lupus erythematosus. Clin Rheumatol 32(8):1155–1160

    Article  PubMed  Google Scholar 

  8. Liberati A, Altman DG, Tetzlaff J et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med 151(4):W65–W94

    Article  PubMed  Google Scholar 

  9. Dreyer L, Jacobsen S, Juul L, Terslev L (2014) Ultrasonographic abnormalities and inter-reader reliability in Danish patients with systemic lupus erythematosus - a comparison with clinical examination of wrist and metacarpophalangeal joints. Lupus. doi:10.1177/0961203314561666

    PubMed  Google Scholar 

  10. Yoon HS, Kim KJ, Baek IW et al (2014) Ultrasonography is useful to detect subclinical synovitis in SLE patients without musculoskeletal involvement before symptoms appear. Clin Rheumatol 33(3):341–348

    Article  PubMed  Google Scholar 

  11. Iagnocco A, Ceccarelli F, Rizzo C et al (2014) Ultrasound evaluation of hand, wrist and foot joint synovitis in systemic lupus erythematosus. Rheumatology 53(3):465–472

    Article  PubMed  Google Scholar 

  12. Gabba A, Piga M, Vacca A et al (2012) Joint and tendon involvement in systemic lupus erythematosus: an ultrasound study of hands and wrists in 108 patients. Rheumatology 51(12):2278–2285

    Article  PubMed  Google Scholar 

  13. Torrente-Segarra V, Lisbona MP, Rotes-Sala D et al (2013) Hand and wrist arthralgia in systemic lupus erythematosus is associated to ultrasonographic abnormalities. Joint Bone Spine 80(4):402–406

    Article  PubMed  Google Scholar 

  14. Iagnocco A, Ossandon A, Coari G et al (2004) Wrist joint involvement in systemic lupus erythematosus. An ultrasonographic study. Clin Exp Rheumatol 22(5):621–624

    CAS  PubMed  Google Scholar 

  15. Ossandon A, Iagnocco A, Alessandri C, Priori R, Conti F, Valesini G (2009) Ultrasonographic depiction of knee joint alterations in systemic lupus erythematosus. Clin Exp Rheumatol 27(2):329–332

    CAS  PubMed  Google Scholar 

  16. Delle Sedie A, Riente L, Scire CA et al (2009) Ultrasound imaging for the rheumatologist. XXIV. Sonographic evaluation of wrist and hand joint and tendon involvement in systemic lupus erythematosus. Clin Exp Rheumatol 27(6):897–901

    CAS  PubMed  Google Scholar 

  17. Mosca M, Tani C, Carli L et al (2015) The role of imaging in the evaluation of joint involvement in 102 consecutive patients with systemic lupus erythematosus. Autoimmun Rev 14(1):10–15

    Article  PubMed  Google Scholar 

  18. Wright S, Filippucci E, Grassi W, Grey A, Bell A (2006) Hand arthritis in systemic lupus erythematosus: an ultrasound pictorial essay. Lupus 15(8):501–506

    Article  CAS  PubMed  Google Scholar 

  19. Ball EM, Gibson DS, Bell AL, Rooney MR (2014) Plasma IL-6 levels correlate with clinical and ultrasound measures of arthritis in patients with systemic lupus erythematosus. Lupus 23(1):46–56

    Article  CAS  PubMed  Google Scholar 

  20. Grassi W, Filippucci E, Farina A, Cervini C (2000) Sonographic imaging of tendons. Arthritis Rheum 43(5):969–976

    Article  CAS  PubMed  Google Scholar 

  21. Grassi W, Lamanna G, Farina A, Cervini C (1999) Synovitis of small joints: sonographic guided diagnostic and therapeutic approach. Ann Rheum Dis 58(10):595–597

    Article  CAS  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

The scientific guarantor of this publication is Mittermayer Barreto Santiago M.D., PhD. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was not required because the article is a systematic review.

M.S. received a scholarship from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq).

Author information

Authors and Affiliations

  1. Escola Bahiana de Medicina e Saúde Pública, Av. Dom João VI, 275, 40290-000, Salvador, Bahia, Brazil

    Carolina F. Lins & Mittermayer B. Santiago

  2. Serviços Especializados em Reumatologia da Bahia, Rua Conde Filho, 117, Graça, Salvador, Bahia, Brazil, CEP 40150-150

    Mittermayer B. Santiago

Authors
  1. Carolina F. Lins
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mittermayer B. Santiago
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mittermayer B. Santiago.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lins, C.F., Santiago, M.B. Ultrasound evaluation of joints in systemic lupus erythematosus: a systematic review. Eur Radiol 25, 2688–2692 (2015). https://doi.org/10.1007/s00330-015-3670-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-015-3670-y

Keywords

Search

Navigation