Diagnostic use of superb microvascular imaging in evaluating septic arthritis of the manubriosternal joint: A case report

Figure 2 High-resolution ultrasound images with superb microvascular imaging of the manubriosternal joint, longitudinal views. A: The pseudo-capsular layer is separated by intra-articular effusion and synovial hypertrophy (white arrows) with remarkable power Doppler signals; B: Four-month follow-up by power Doppler; C: Color superb microvascular imaging (SMI) visualizes slow flow vascularity more sensitive than conventional power Doppler. Active synovial inflammation with subsequent effusion formation allows suspecting of septic arthritis; D: Four-month follow-up by color SMI; E: Monochrome SMI helps to catch the eye and highlights true flow signals of small vessels in the grey map. F: Four-month follow-up by monochrome SMI. There is still mild peri- and intra-articular vascularity or arthritis and more eroded joint margins. A diagnostic ultrasound system (CANON TUS-AI800, Canon medical systems corp, Shimoishigami, Otawara-shi, Japan) equipped with a linear transducer with the following settings (14 MHz frequency) was used; ms: Manubrium of the sternum; bs: Body of the sternum.