![]() ![]() Synovial fluid is also important because it is the medium through which oxygen and other nutrients are delivered to the cartilage, which does not have a blood supply of its own. It is a clear, slightly viscous fluid that lubricates the joint and allows it to move freely throughout its entire range of motion. It is encapsulated in and created by the synovium, which surrounds the joints and helps stabilize all of its components. Synovial fluid is a gel-like fluid that fills most of the joints of the body. If left untreated, rheumatoid arthritis will only worsen. Other common symptoms of rheumatoid arthritis include severe fatigue, mild fever, loss of appetite, changes to the skin and nails, and anemia. This pain is often accompanied by swelling, stiffness, and muscle pain in the musculature surrounding a joint. One of the most obvious signs of rheumatoid arthritis is a recurrent, constant pain in the joints. This afront by the immune system causes inflammation that destroys cartilage and the synovium, a tough capsule surrounding a joint that, together with the synovial fluid, holds it in place. In patients with autoimmune diseases like rheumatoid arthritis, the immune system, which is designed to protect the body from foreign invaders, gets confused and starts to attack healthy tissue in the case of rheumatoid arthritis, the immune system attacks otherwise healthy joints. may see lateral meniscal pathology (e.g.Rheumatoid arthritis is a debilitating form of arthritis that is caused by the body’s own defenses.evaluate the lateral collateral ligament in long axis.evaluate the distal iliotibial band in long axis (located between the anterior and middle third of the lateral knee).normally no fluid in the superficial infrapatellar bursa.small amount of fluid in the deep infrapatellar bursa is normal.tendon may appear enlarged just prior to insertion.anisotropy may falsely indicate a change in echogenicity.tendon should be constant in size and echogenicity through its course without detectable color Doppler flow.evaluate the patellar tendon and patellar bursae.evaluate the medial patellar articular facet (lateral facet not visible on ultrasound).useful for examination of the trochlear cartilage.extent of the medial/lateral suprapatellar recess should also be visualized.suprapatellar recess interdigitates between, distension representing likely effusion, most sensitive region.evaluate the suprapatellar and parapatellar joint recesses.transverse and longitudinal images of the quadriceps tendon from its myotendinous junctions to its attachment on the superior patella (rectus femoris myotendinous junction is more cranial than the vastus junctions). ![]() The knee is flexed 20-30° (flexion of the knee tightens the extensor tendons, decreasing the chance of anisotropy occurring in a lax tendon): ![]() A typical overall protocol is as follows 1: Anterior knee There are multiple possible approaches to imaging the knee with ultrasound. Knee ultrasound is somewhat limited compared with ultrasound examinations of other joints because the cruciate ligaments and the entirety of the meniscus are usually difficult to visualize. Ultrasound of the knee allows high-resolution imaging of superficial knee anatomy while simultaneously allowing dynamic evaluation of some of the tendons and ligaments. ![]()
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