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Ultrasound power Doppler synovitis — SCE Rheumatology MCQ

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ModerateMusculoskeletal investigationsUltrasound power Doppler synovitisSCE Rheumatology

A 56-year-old woman has painful swollen wrists and MCP joints despite normal CRP. Clinical examination is equivocal because of obesity and fibromyalgia. Ultrasound shows grey-scale synovial hypertrophy with power Doppler signal in multiple MCP joints. What does this most strongly indicate?

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Correct answer: C — Active inflammatory synovitis

Power Doppler signal within synovial hypertrophy supports active inflammatory synovitis. Fibromyalgia may coexist and amplify pain, but it does not produce Doppler synovitis. Ultrasound can help discriminate inflammatory activity when examination and CRP are uncertain.

Reference: EULAR imaging recommendations in inflammatory arthritis