Inflamed retrocalcaneal bursa and Achilles tendonitis in psoriatic arthritis demonstrated by ultrasonography

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Abstract
OBJECTIVE To demonstrate the use of high resolution ultrasound measurements and power Doppler mode in the diagnosis and follow up of a patient with psoriatic arthritic with retrocalcaneal bursitis and Achilles tendonitis. METHODS An outpatient based ATL HDI 3000 ultrasound equipment was used with a CL10–5 MHZ 26 mm probe and musculoskeletal software. Real time B mode and power Doppler mode were used to detect changes in structure and blood flow. RESULTS Unilateral retrocalcaneal bursitis and Achilles tendonitis were demonstrated by sonography. Power Doppler mode was useful to demonstrate an increased blood flow around an abnormal retrocalcaneal bursa. A follow up examination showed marginal thickening of the Achilles tendon without any bursitis. CONCLUSIONS Ultrasonography is an objective method in the confirmation of clinical diagnosis after physical examination. During the examination it is possible to gain not only qualitative but also quantitative data. A comparative study with quantitative data is possible in longitudinal studies.