Synovitis Elbow

Musculoskeletal Reversible severe synovitis has been associated with everolimus in a 32-year-old male heart transplant recipient who switched from mycophenolate mofetil to everohmus and 1 week later developed arthralgia in the right elbow both knees were swollen, erythematous, and accompanied by localized sensations of burning [46" ]. The symptoms resolved completely within 2 weeks of withdrawal of everolimus. 

Fig. 8.68a,b. Synovitis of the elbow joint posterior joint recess, a Longitudinal 12-5 MHz US image over the posterior olecranon recess with b T2w SE MR imaging correlation in a patient with rheumatoid arthritis presenting with painful elbow and loss of extension. US shows a bulk of hypoechoic synovial pannus fiUing the recess (arrows). Deep to the triceps muscle (tm), the posterior fat pad (asterisks) is elevated by the pannus. Note the prominence of the tip of the olecranon (O) and the humeral trochlea (TR) bulging within the recess... 

Fig. 8.71a,b. Synovitis of the elbow joint pitfall. a,b Transverse 12-5 MHz US images over the posterior olecranon recess a in a normal subject and b in a patient with rheumatoid arthritis and an olecranon recess (arrows) appears markedly distended by fluid. In a, the normal hypoechoic fat contained. In b the olecranon fossa, between the lateral (LE) and medial (ME) epicondyles, should not be confused with the synovitis process shown in b. In doubtful cases, careful dynamic examination with elbow flexion and extension movements may be helpful for the diagnosis. Note the erosion (arrowhead) on the posteromedial aspect of the lateral epicondyle. T, distal triceps tendon... 

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