Intact cortical bone | |
Single small erosion (diameter: ≤2 mm) | |
Single large erosion (diameter: >2 mm) or 2 small erosions or 1 large and 1 small erosion | |
2 large erosions or ≥3 erosions, regardless of size |
Disease | Joint involvement | Key features on HRUS |
---|---|---|
Degenerative | ||
Osteoarthritis (OA) | Knee Hand (1st CMC, DIP, PIP) Hip |
Cartilage thinning and irregularity Intrasubstance echogenicity in cartilage Marginal Osteophytes Joint space narrowing Effusion Synovitis Medial meniscal extrusion |
Inflammatory | ||
Rheumatoid arthritis (RA) | MCP PIP Wrist MTP |
Synovitis Effusion Erosions Tenosynovitis Bursitis Enthesitis Tendinitis Rheumatoid nodules |
Juvenile idiopathic arthritis | Knee Ankle Hand Elbow Hip |
Synovitis Tenosynovitis Cartilage loss Enthesitis Bursitis Tendinitis |
Lupus arthritis | MCP PIP Wrist |
Synovitis Tenosynovitis |
Spondyloarthropathies (SpA) | Hand Knees Wrist |
Enthesitis Synovitis Tenosynovitis Bursitis Paratenonitis Dactylitis |
Polymyalgia rheumatica (PMR) | Shoulder Hip |
Bursitis Effusion |
Crystal deposition diseases | ||
Gout | 1st MTP Tarsal Ankle Knee |
Double contour sign Tophi Erosions Synovitis Effusion |
Pseudogout | Knee Wrist Ankle |
Intracartilaginous echogenic crystal deposits Synovitis Effusion Enthesitis |
Normal joint | No GS-detected SH and no PD signal (within the synovium) | |
Minimal Synovitis | Grade 1 SH and ≤ Grade 1 PD signal | |
Moderate Synovitis | Grade 2 SH and ≤ Grade 2 PD signal or Grade 1 SH and Grade 2 PD signal | |
Severe Synovitis | Grade 3 SH and ≤ Grade 3 PD signal or Grade 1 or 2 SH and Grade 3 PD signal |