OBJECTIVE: The aim of the present study was to illustrate the (potential) diagnostic role of high resolution US images in assessing the elementary lesions of dactylitis. METHODS: Using high-frequency US machines/probes, we matched the micro-anatomical cadaveric architecture of the digit with multiple sonographic findings of dactylitis. High-sensitive color/power Doppler assessments have also been performed to evaluate the digital microvasculature. DISCUSSION: Modern US equipment/features guarantee prompt and in-depth B-mode and color/power Doppler imaging of tiny anatomical structures of the digit which are usually not properly visible with standard US machines. More specifically, hypervascularization of the digital subcutaneous tissue, fibrous pulleys of flexor tendons, dorsal synovial pads as well as pathological changes of the distal entheseal anchorage network can be accurately detected. CONCLUSION: In clinical practice, high-end US equipment can be used to accurately assess the digits in patients with dactylitis. This way, simple and convenient sonographic diagnosis of different elementary lesions can be timely established.

Department of Basic Medical Sciences Neurosciences and Sense Organs Aldo Moro University of Bari Bari Italy

Department of Biological and Environmental Science and Technologies University of Salento Lecce Italy

Department of Pediatrics Vittore Buzzi Children's Hospital University of Milan 20154 Milan Italy

Department of Physical and Rehabilitation Medicine Ankara Hacettepe University Medical School Ankara Turkey

Department of Physical Medicine and Rehabilitation and Community and Geriatric Research Center National Taiwan University Hospital Bei Huy Branch Taipei Taiwan

Institute of Anatomy 1st Faculty of Medicine Charles University Prague Czech Republic

Physical and Rehabilitation Medicine Unit Luigi Sacco University Hospital ASST Fatebenefratelli Sacco Milan Italy

Rheumatology Clinic University Hospital of Basel Basel Switzerland

UZR Ultraschallzentrum und Institut für Rheumatologie Basel Switzerland

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