Learning objectives
To describe and illustrate the ultrasonographic features of the most common inflammatory and metabolic arthropathies,
and discuss the role of ultrasound examination in both the diagnosis and follow-up of these diseases.
Background
In the spectrum of inflammatory and metabolic arthropathies,
the course of the disease largely depends on its early diagnosis and prompt institution of targeted therapy.
While conventional radiography is routinely used in clinical practice to depict structural changes during the course of the disease,
characterized by joint space narrowing,
juxta-articular osteopenia,
subchondral cysts,
bony erosions,
luxation and ankylosis,
ultrasound can detect early changes of the disease such as synovial hypertrophy,
tenosynovitis,
soft tissue neovascularization,
joint effusion and early erosions.
For this reason,
and specially due...
Imaging findings OR Procedure Details
The inflammatory arthritides,
of which rheumatoid arthritis (RA) is the most common,
are a group of chronic,
often debilitating,
disorders characterized by synovial inflammation and progressive joint destruction.
Early inflammatory arthritis may develop into established RA or another form of arthropathy,
may spontaneously resolve,
or may remain undifferentiated.
Common US findings in rheumatologic diseases – terms and definitions
The Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT) has standardized the imaging thecnique and defined the most common pathologic US findings of rheumatologic diseases in clinical...
Conclusion
High-resolution US provides a safe and cost-effective evaluation of rheumatologic arthropaties,
with increasing evidence that supports its use in clinical practice for both diagnosis and follow-up purposes.
Ultrasound is particularly useful in the detection of active inflammation and early erosive changes.
References
Huizinga,
T.,
Nigrovic,
P.,
Ruderman,
E.,
& Schulze-Koops,
H.
(2011).
Utility of ultrasound joint counts in the prediction of rheumatoid arthritis in patients with very early synovitis: Commentary.
International Journal of Advances in Rheumatology,
9(3),
105.
https://doi.org/10.1136/ard.2010.131573
D’Agostino,
M.
A.,
Wakefield,
R.
J.,
Berner-Hammer,
H.,
Vittecoq,
O.,
Filippou,
G.,
Balint,
P.,
… Le Bars,
M.
(2016).
Value of ultrasonography as a marker of early response to abatacept in patients with rheumatoid arthritis and an inadequate response to methotrexate: Results from the APPRAISE study.
Annals of...