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The use of ultrasound in the management of monoarthritis in anoutpatient settingLian TY, Kong KO, Cheng YK, Chng HH, Tan Tock Seng Hospital,Singapore

Objectives: Monoarthritis is not an uncommon problem in rheumatol-ogy clinical practice with the main concern being an underlying infec-tive etiology . In our outpatient setting, patients are first assessed by therheumatologist and subsequently referred for a biopsy causing somedelay in management of the arthritides. The introduction of an ultra-sound scanner in outpatients has facilitated fast tracking of investiga-tions including biopsy of the affected joint. The objective of this studyis to evaluate the usefulness of ultrasound guided needle biopsy inmonoarthritis.Methods: Thirty patients with monoarthritis who underwent ultra-sound and biopsy of monoarthritis were reviewed.Results: Majority of the patients were Chinese (73%), median age of55.5 years with M:F ratio of 6.5:1. The main indication for ultrasoundand biopsy was to rule out infection and the main sites were ankles(27%), fingers (17%), wrists (17%), metacarpal-phalangeal joints(10%) and elbows (10%). Majority of the patients had evidence ofsynovitis (87%), increased Doppler (93%), effusions (43%) and teno-synovitis (30%). Majority (87%) had no evidence of infection onculture and this facilitated early initiation of DMARD.Conclusions: Patients can now be provided with a one-stop centerwhereby immediate imaging and biopsies can be performed allowingability to plan and target interventions effectively.

3360

The correlation between ultrasonographic findings andLequesne’s index in patients with knee osteoarthritisChen H-C, Tsai W-C, Chang Gung Memorial Hospital, Taiwan

Objectives: To measure the longitudinal length and thickness of su-prapatellar recess and thickness of parapatellar recess in patients withknee osteoarthritis and to determine the correlation of Lequesne’sindex.Methods: High-resolution linear assay ultrasound was used to measurethe suprapatellar recess and parapatellar recess. Lequesne’s index wasassessed after the ultrasonographic examination.Results: The suprapatellar recess length and total synovial thickness(TST) are 31.2 � 7.9 mm and 6.3 � 1.0 mm. Medial and lateralparapatellar recess TST are 2.7 � 1.3 mm and 3.1 � 1.5 mm. Corre-lation between length and TST of suprapatellar recess and parapatellarrecess with Lequesne’s index were statistically significant (p � 0.05).Conclusions: Suprapatellar recess length, medial patellar recess TSTand lateral patellar recess TST have high correlation with Lequesne’sindex. Ultrasound is ideal for evaluation of joint effusion, synovitis andpain for OA knee patient.

3361

Ultrasound imaging of tendon disease: A pictorial reviewZoumpoulis PS, Delimpasis G, Bechrakis I, Ioannou I, Pahos K,Chatzimihail C, Echonet: the Ultrasound Network www.echonet.gr,Greece

Objectives: To demonstrate the role of ultrasound in tendon pathology.Methods: Outpatients as well as inpatients suffering from orthopedicor rheumatological disorders were examined using 7.5 – 14 MHztransducers.Results: Ultrasonography proved to be a useful tool in depictingtendons, thus reducing the need for further Imaging. Dynamic tests

gave the opportunity to clinically assess the painful areas and revealoccult pathology. Patients tolerated it very well, especially compared toMRI. Inpatients were hospitalized for a shorter period and outpatientsspent less time waiting for more sophisticated examinations.Conclusions: High frequency (7.5–14 MHz) ultrasound is a quick,widely available, cost effective and well tolerated means for tendonimaging. In the vast majority of cases it establishes or confirms thediagnosis, eliminating further costly, time-consuming imaging exams.

3362

Collections and cysts in and around the joints: The role ofultrasoundZoumpoulis PS, Delimpasis G, Bechrakis I, Ioannou I, Plagou A,Chatzimihail C, Echonet: the Ultrasound Network www.echonet.gr,Greece

Objectives: To document the utility of ultrasound imaging in depictingintra or periarticular fluid.Methods: Twenty-three individuals (15 males, 8 females, mean age37 y) with suspected fluid collections, painful and palpable or not, wereinitially examined by ultrasound. Twenty of them were positive forsuch a finding (eight Baker cysts, three meniscal cysts, four bursae, twoganglia, three intraarticular fluid collections).Results: A wide spectrum of cysts and fluid collections around and/orin the joints can be revealed and accurately diagnosed by high fre-quency ultrasonography (7.5–14 MHz). Color Doppler ultrasound(CDU) adds significant information regarding vascularity, while dy-namic assessment remains an option.Conclusions: Ultrasound can be the first imaging modality in case ofperiarticular fluid collections and suspected hydrops (excessive intra-articular fluid), offering many advantages over CT or even MRI.

3363

US imaging of ganglia near the medial and lateral gastrocnemiusinsertionsLee K, van Holsbeeck M, Henry Ford Hospital, United States ofAmerica

Objectives: To retrospectively evaluate the ultrasound (US) features ofcystic lesions near the insertions of the medial and lateral gastrocne-mius that can look like tumor, with MR and histopathologic correlation.Methods: US and MR examinations of eight patients who presentedwith posterior knee pain and swelling concerning for a mass wereretrospectively evaluated by a musculoskeletal radiologist. Analysisincluded age, gender, size, location, MR and histopathologic correla-tion of these lesions.Results: Seven US and seven MR exams of eight patients (5:3 �female:male; age range, 44 to 70; mean age, 58.7) were reviewed fromJune 2003 to March 2005. Cyst size ranged from 1.0 to 8.5 cmcraniocaudally and 2.0 to 4.0 cm axially. Almost all lesions werewell-defined, anechoic to hypoechoic and with a few thin septations.However, one lesion was an ill-defined heterogeneous mass extendingfrom the popliteal space and breaking through the vastus lateralismuscle. Location varied from medial to lateral, and the cysts wereseparated from the sub-gastrocnemius/semimembranosus bursa. MRIappearance varied from typical to atypical characteristics of a benigncyst. Ultrasound-guided biopsy in all of the cases confirmed a benignganglion cyst, except for one lesion that was a benign synovial cyst.Conclusions: Cystic lesions near the medial and lateral gastrocnemiuspredominately demonstrate benign ultrasound and MRI features. His-topathologic examination supported the diagnosis of a benign cyst.

Abstracts P251