Background/Purpose:

Patients suffering from acute sarcoidosis frequently present with bilateral painfull swelling of the ankles, establishing ankle arthritis as a hallmark of Löfgren’s syndrome. Standardized high resolution musculoskeletal ultrasound (MUS) including power Doppler has been utilized to further characterize the nature of the ankle swelling in patients presenting with Löfgren’s syndrome.

Methods:

Ankle joints of 36 consecutive patients suffering from Löfgren’s syndrom were investigated by high resolution MUS using B- and power Doppler mode. Presence of effusion / synovitis and tenosynovitis has been determined, and hyperperfusion was scored in a semiquantitative fashion (grade 0-3).

Results:

The majority of patients (26/36; 72,2%)  did not present characteristic arthrosonographic findings of an acute arthritis (distension of the capsule and hyperperfusion). Ankle joint effusion was only observed in 9 of the 36 patients (25%). Remarkably, 88,8% of these patients had an ankle effusion grade I and only 11,1% presented an effusion grade II. Instead, an extensive subcutaneous edema indicating periarthritis was detected in 23 of 26 patients (88,4%). In addition, tenosynovitis could be visualized in 14 patients (38,8%).

Conclusion:

Utilizing MUS including power Doppler, the present results clearly demonstrate that ankle swelling in patients suffering from Löfgren´s syndrome is predominantely due to periaticular soft tissue swelling and tenosynovitis. In contrast, distinct articular synovitis is rare and if present only of mild degree without relevant power Doppler activity.

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« Back to 2012 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/evaluation-of-ankle-swelling-due-to-lofgrens-syndrome-a-pilot-study-using-b-mode-and-power-doppler-ultrasonography/