DETECTION OF SOFT-TISSUE HYPEREMIA - VALUE OF POWER DOPPLER SONOGRAPHY

OBJECTIVE. Power Doppler sonography is a new technique that offers ext ended dynamic range over that provided by conventional color Doppler i maging, thereby facilitating measurement of tissue perfusion, We evalu ated the efficacy of power Doppler sonography in depicting soft-tissue hyperemia in musculoskeletal inflammatory conditions. SUBJECTS AND ME THODS. Twenty-three patients with predominantly unifocal musculoskelet al symptoms were evaluated with conventional gray-scale imaging and po wer Doppler sonography. The shoulder was evaluated in 14 patients, the elbow in three, and various other sites in six. For comparison purpos es, the contralateral asymptomatic joint or site was examined in 17 ca ses. Fluid collections were aspirated in seven patients. RESULTS. Soft -tissue hyperemia was seen on power Doppler sonograms at the symptomat ic site(s) in 22 of 23 cases studied, with an appearance ranging from frank tissue blush to large, isolated peritendinous/peribursal vessels . Findings associated with hyperemia included rotator cuff tendinitis and/or tear, bursitis, and symptomatic wrist ganglia. Findings on powe r Doppler sonograms were normal in one patient who had a small, steril e hip joint effusion, and findings on subsequent scintigrams, pelvic r adiographs, and CT scans were normal. CONCLUSION. Power Doppler sonogr aphy consistently shows hyperperfusion associated with musculoskeletal inflammatory disease. As such, it represents a useful adjunct to gray -scale sonography in these settings, particularly as findings on conve ntional sonograms in inflammatory conditions can be nonspecific.