Aim: To evaluate the morphostructural aspects and nail vascularity in the nail unit of patients with psoriasis, and to evaluate whether there are differences among psoriatic patients with and without nail involvement. Material and methods: Nail plates and nail bed changes, nailfold vessel resistance index (NVRI), power and color Doppler blood flow appearances were investigated in 23 patients with moderate-to-severe psoriasis, with and without nail involvement, and compared to those of 11 healthy participants. Results: Ventral nail plate deposits were present only in psoriasis patients. Irregular or totally fused nail plates and increased nail plate thickness was frequently observed in psoriasis patients compared to controls. NVRI was increased in psoriatic patients' nails compared to controls (0.62 vs. 0.57, p<0.0001). In the psoriasis patient group there was significant statistical difference in NVRI in patients with nail involvement compared to those without (0.66 vs. 0.55, p<0.0001). Conclusions: High-frequency gray scale sonography provides valuable information regarding morphostructural changes in nail unit structure in patients with psoriasis. Power Doppler imaging enables blood flow assessment in psoriasis nail induced changes.

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Temporal myositis is a rare inflammatory disease of the temporal muscle. We report a case of unilateral temporal myositis, in which a polymyositis was diagnosed two years thereafter. Although focal myositis may rarely herald polymyositis, isolated temporal myositis preceding inflammatory myopathies has not been described, to our knowledge. In the setting of a temporal pain and swelling, ultrasonography may help in diagnosis, biopsy guidance, disease extension, and progression assessment. Further studies are necessary to establish the role of elastography in differentiating between muscle inflammation and hypertrophy.

Aim: The aim of the study was to assess the usefulness of obtaining a 90 0 angle between the plane of the osteochondral plate and the surface of the transducer during standard hip ultrasonography according to Graf method. Material and methods: In this retrospective study 1078 patients (2156 hips) were included examined between 2008 and 2014 for developmental dysplasia of the hip (DDH) ultrasound screening. The patients were divided in two groups. Group I consisted of 402 patients examined between January 2008 and December 2011 using the standard Graf method. Group II consisted of 676 patients examined from January 2012 to December 2014 using the Graf method with an additional criterion: 90 0 angle between the plane of the osteochondral plate and the surface of the transducer. Results: We found more dysplastic patients in group I comparing to group II: 55 (13.7%) and 38 (5.6%) respectively. The difference in the incidence of patients diagnosed with DDH was highly significant (p<0.001). The mean alpha angle value in group I was 65.31 0 , respectively 67.52 0 for group II (p<0.001). Conclusion: The new osteochondral plate sign has the potential to reduce the overdiagnosis of DDH and provide a better tailored approach to borderline hips.

Psoriasis represents a common, chronic inflammatory disease involving the skin, nails and joints. Nail psoriasis in usually investigated and diagnosed by clinical examination. New insights support ultrasonography as being a non-invasive reliable imaging technique for studying nail and skin involvement in patients with psoriasis. Power Doppler frequency, higher than 10MHz enables a very sensitive detection and semiquantitative assessment of the blood flow at the dermal level and in the nail bed. In this review we will present the main US findings in skin and nail psoriasis, and discuss the importance of ultrasonography in diagnosing and monitoring psoriasis vulgaris.