Semiquantitative Evaluation of Extrasynovial Soft Tissue Inflammation in the Shoulders of Patients with Polymyalgia Rheumatica and Elderly-Onset Rheumatoid Arthritis by Power Doppler Ultrasound

Figure 6

Representative ultrasound (US) images for grading of synovial pathology of the shoulder. Images from the shoulders of patients with polymyalgia rheumatica (PMR) (a–d) and elderly-onset rheumatoid arthritis (EORA) with PMR-like onset (e–h) are shown on gray-scale (c, e, and g) and power Doppler (a, b, d, f, and h) ultrasonograms. The shoulder was in a neutral position (a, b, e, f, and h), in a modified Crass position (c, d), or internally rotated (g). Moderate hyperemia was detected in the long head of biceps tendon sheath () on transverse (a) and longitudinal (b) scans. Mild synovial effusion (c) and moderate hyperemia (d) were detected in the subacromial bursa (arrowheads). Severe synovial effusion (e) and severe hyperemia (f) were detected in the subcoracoid bursa (†) and subdeltoid bursa (‡). Moderate synovial proliferation (g) and severe hyperemia (h) were detected in the glenohumeral joint ().

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