The aim of this study was to characterize the pathological conditions of symptomatic ankles in patients with rheumatoid arthritis (RA) using power Doppler sonography (PDS). We analyzed 17 consecutive ultrasonography (US) records of RA patients with symptomatic ankles who underwent B-mode ultrasonography (BUS) combined with PDS of their ankles in our department because of clinical need. Correlations between US findings and clinical and serological data were assessed. The diagnostic capabilities of BUS and PDS were also compared. Common US findings were talocrural synovitis (76%), subtalar synovitis (71%), and talonavicular synovitis (59%). Tenosynovitis around the ankle was detected in ten patients (59%), including several cases of tenosynovitis of tibialis posterior (41%) and tenosynovitis of peroneus longus and brevis (35%). Achilles tendon enthesitis was detected in six patients, and retrocalcaneal bursitis was detected in five. Compared with BUS, PDS offers demonstrably superior diagnostic capability for the detection of rheumatoid ankle diseases, especially subtalar joint synovitis and peroneal tenosynovitis. Rheumatoid factor (RF) levels were significantly higher in patients with tenosynovitis than in patients without tenosynovitis. PDS is an excellent modality for diagnosing both intra- and extracapsular synovitis in rheumatoid ankles. Using PDS, we found positive association between ankle tenosynovitis and RF levels in RA patients.

No abstract

Some patients are troubled by leg swelling following saphenectomy long after CABG. Postsaphenectomy venous function in the leg has not, however, been well clarified. To determine whether venous dysfunction caused postsaphenectomy swelling, we measured the maximum venous outflow and time constant (tau) in the leg by venous occlusion strain-gauge plethysmography in 45 patients; a venous Doppler test was also conducted in 33 of the 45 at a mean 57.6 +/- 21.3 months after CABG. The saphenous vein was harvested unilaterally from the lower leg or from both the thigh and lower leg in all patients. Edema was seen in 4 patients (8.9%) and 8 reported leg swelling after saphenous vein harvest (17.8%). Legs were classified into three groups: group 1 consisted of 12 with edema or reports of swelling ipsilateral to the saphenous vein harvest site, group 2 consisted of 33 ipsilateral to the saphenous vein harvest without edema, and group 3 consisted of the 45 nonoperated-on, contralateral legs of the same patients as controls. No significant differences were seen in maximum venous outflow, tau, or the incidence of deep vein reflux among groups. No significant relationship was found between venous function and leg swelling occurring delayed after saphenectomy.

The aim of this study was to characterize the pathological conditions of symptomatic ankles in patients with rheumatoid arthritis (RA) using power Doppler sonography (PDS). We analyzed 17 consecutive ultrasonography (US) records of RA patients with symptomatic ankles who underwent B-mode ultrasonography (BUS) combined with PDS of their ankles in our department because of clinical need. Correlations between US findings and clinical and serological data were assessed. The diagnostic capabilities of BUS and PDS were also compared. Common US findings were talocrural synovitis (76%), subtalar synovitis (71%), and talonavicular synovitis (59%). Tenosynovitis around the ankle was detected in ten patients (59%), including several cases of tenosynovitis of tibialis posterior (41%) and tenosynovitis of peroneus longus and brevis (35%). Achilles tendon enthesitis was detected in six patients, and retrocalcaneal bursitis was detected in five. Compared with BUS, PDS offers demonstrably superior diagnostic capability for the detection of rheumatoid ankle diseases, especially subtalar joint synovitis and peroneal tenosynovitis. Rheumatoid factor (RF) levels were significantly higher in patients with tenosynovitis than in patients without tenosynovitis. PDS is an excellent modality for diagnosing both intra- and extracapsular synovitis in rheumatoid ankles. Using PDS, we found positive association between ankle tenosynovitis and RF levels in RA patients.