Application of ultrasound in the diagnosis and monitoring of inflammatory rheumatic diseases

Abstract:

Over the past 20 years, ultrasound has been confirmed as an important imaging technique in patients with inflammatory rheumatic diseases. The ultrasound technique includes B-mode (greyscale) imaging of anatomic structures and blood-flow detection by Doppler technique. The ultrasound is proven to be a more sensitive method for the detection of joint inflammation in comparison to a clinical examination and due to ability of multiplanar assessment is also a more sensitive method for detecting erosions, in comparison to conventional radiographs. By applying ultrasound it is possible to detect disease at an early stage and to treat it early and effectively which prevents later structural changes in the joint and functional limitations, or disability. The importance of ultrasound has been further confirmed by incorporating ultrasound findings for the first time in classification criteria of rheumatic diseases (ACR / EULAR’s classification criteria for polymyalgia rheumatica from 2012). Its advantages are noninvasiveness, lack of ionizing radiation, the ability to examine in real-time and at patients’ bedside, and multiplanar evaluation of anatomic structures. With ultrasound navigation it is possible to complete targeted punctures, aspirations and intra-articular applications of medications. 

Key words:
ultrasound; diagnostics; early arthritis; rheumatology