Ultrasonography of synovium in rheumatological diseases

The use of X-ray radiation has been a basic method in radiological estimation of joint degeneration for many years. However, conventional X-ray radiography does not reveal early changes. Changes in soft tissues and synovium are also invisible in the X-ray radiograph. During the last years ultrasonographic examination of joints has been considered by rheumatologists and radiologists as the first examination in early diagnostics of rheumatological diseases, especially in diagnosis of rheumatoid arthritis and monitoring of progress of the disease. It has become possible due to growing availability of ultrasonographic machines as well as improvement of frequency of linear transducers up to 16-18 MHz and improvement of modern software. Due to these changes it is currently possible to observe effusion in the joints and tendon sheath, inflammatory changes in the synovium and presence of inflammatory granulation in periarticular tissue. Modern ultrasonographic machines also allow one to observe changes of the bone surface such as erosion or irregularity of the periosteum. Under ultrasonographic control uptake of biological material and application of medicine are also possible.