SONOGRAPHIC DIAGNOSIS OF RHEUMATIC DISEAS ES

The aim of this study was to establish a diagnostic concept for imagin g of rheumatic diseases including high-resolution sonography in conjun ction with plain film radiography and clinical findings. Sonography is particulary useful for imaging of deep-seated joints, muscles and ten dons, e.g. the rotator cuff of the shoulder, the ligaments of the knee , various bursae, or malignant neoplasms. However, diagnosis of intern al derangements of a joint is established to better advantage by means of MRI and arthroscopy. Baker's cyst of the knee is the most common f orm of bursitis with a significant amount of abnormal fluid accumulati on. With sonography, diagnosis can be established readily and differen tiation from other popliteal masses is possible. Furthermore, it is po ssible to establish the degree of tendinitis of the rotator cuff or of the Achilles tendon. This may be of value to determine the risk of te ndon rupture sonographically. Palpable masses should be evaluated with MRI; however, with the help of plain film radiography and sonography a first step in characterising the composition and extent of a mass is possible. Therefore, a combined evaluation of plain films, sonograms, and clinical findings is mandatory for imaging rheumatic diseases pri or to other imaging modalities.