Stephen Bird

Hi Enock,

Great to hear from you,

With rheumatology it is all about synovitis and erosions. I use slow flow Doppler like SMI or equivalent, and look at the joint capsules for evidence of flow which suggests synovitis. The synovitis comes well before the erosions so it is important to make the diagnosis before the erosions appear as long term medicated outcomes are much better.
With hands which is most common look on the radial aspect of the MCP joints between the hyaline cartilage and the joint capsule. It’s called the bare area and is the most sensitive spot for RA erosions
RA likes the mcp and pip joints but not so much the dip .
It also likes the distal radioulnar joint and radiocarpal joint so look there also.
I have attached a few schematics I have made with the common distribution for RA, OA and gout in the hand.


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