Is ultrasound changing the way we understand rheumatology? Including ultrasound examination in the classification criteria of polymyalgia rheumatica and gout.

Codreanu, Cătălin; Enache, Luminița

doi:10.11152/mu.2013.2066.171.ccle

Cited by 9 publications

(10 citation statements)

References 50 publications

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“…Ultrasonography (US) has recently been proposed for these purposes. 10 , 11 The new American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) gout classification criteria are the first to incorporate US evidence of the double contour (DC) sign, an articular cartilage abnormality related to the deposition of crystals on the surface of the hyaline cartilage, as a sign specific to gout. 12 The specificity and sensitivity of other gout-related elementary US lesions, such as the presence of tophi, still need to be evaluated in prospective trials.…”

Section: Introductionmentioning

confidence: 99%

An optimal ultrasonographic diagnostic test for early gout: A prospective controlled study

et al. 2017

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ObjectiveTo identify the optimal sites for classification of early gout by ultrasonography.MethodsSixty patients with monosodium urate crystal-proven gout (25 with early gout [≤2-year symptom duration], 35 with late gout [>2-year symptom duration], and 36 normouricemic healthy controls) from one centre were prospectively evaluated. Standardized blinded ultrasound examination of 36 joints and the triceps and patellar tendons was performed to identify tophi and the double contour (DC) sign.ResultsUltrasonographic sensitivity was lower in early than late gout. Binary logistic regression analysis showed that two ultrasonographic signs (tophi in the first metatarsophalangeal joint [odds ratio, 16.46] and the DC sign in the ankle [odds ratio, 25.18]) significantly contributed to the final model for early gout diagnosis (sensitivity and specificity of 84% and 81%, respectively). The inter-reader reliability kappa value for the DC sign and tophi was 0.712.ConclusionsFour-joint investigation (both first metatarsophalangeal joints for tophi and both ankles for the DC sign) is feasible and reliable and could be proposed as a screening test for early ultrasonographic gout classification in daily practice.

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Section: Introductionmentioning

confidence: 99%

An optimal ultrasonographic diagnostic test for early gout: A prospective controlled study

et al. 2017

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“…The past several years have brought more information confirming the necessity to support clinical assessment with imaging for early disease detection, its monitoring (treatment efficacy) and identification of complications (joint damage) ( 22 ) . The recommendations presented above were created by experts, mostly rheumatologists.…”

Section: Discussionmentioning

confidence: 99%

Rola ultrasonografii w diagnostyce chorób reumatycznych w świetle wytycznych ACR/EULAR

et al. 2016

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In the past years, ultrasound imaging has become an integral element of the diagnostic process in rheumatic diseases. It enables the identification of a range of inflammatory changes in joint cavities, sheaths and bursae, and allows their activity to be assessed. In 2012, experts of the European Society of Musculoskeletal Radiology prepared recommendations concerning the role of ultrasonography in the diagnosis of musculoskeletal diseases. Ultrasound was considered the method of choice in imaging peripheral synovitis. Moreover, ultrasound imaging has been popularized thanks to the new classification criteria for rheumatoid arthritis issued by the American College of Rheumatology and European League Against Rheumatism in 2010. They underline the role of ultrasound imaging in the detection of articular inflammatory changes that are difficult to assess unambiguously in the clinical examination. These criteria have become the basis for recommendations prepared by experts from the European League Against Rheumatism concerning medical imaging in rheumatoid arthritis. Nine of ten recommendations concern ultrasonography which is relevant in detecting diseases, predicting their progression and treatment response, monitoring disease activity and identifying remission. In the new criteria concerning polymyalgia rheumatica from 2012, an ultrasound scan of the shoulder and pelvic girdle was considered an alternative to clinical assessment. Moreover, the relevance of ultrasonography in the diagnosis and monitoring of peripheral spondyloarthropathies was widely discussed in 2014 during the meeting of the European League Against Rheumatism in Paris.

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“…Recently USG has been incorporated as diagnostic criteria in Polymyalgia rheumatica. 42 Some of the USG features of Takayasu arteritis have been illustrated in Fig. 4.…”

Section: Spondyloarthropathiesmentioning

confidence: 99%

Ultrasound in musculoskeletal disorder – A new horizon in rheumatology

Mondal

Ghosh

2015

Indian Journal of Rheumatology

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a b s t r a c tEarly detection of rheumatological diseases is an important step in prevention of permanent damage and deformities. Conventional radiography has traditionally been used as a diagnostic tool in rheumatology but is incapable to detect early changes in the periarticular tissues and bones. MRI has gained undoubted superiority for detection of soft tissue pathologies and early bony inflammatory changes but its widespread use is restricted by multiple factors. Ultrasonography (USG) is a promising tool for bridging this gap. Though the use of USG in the field of Rheumatology is almost three decades old, recent advancement in technology has made it an attractive imaging tool for early detection various musculoskeletal disorders. The utility of USG is not only limited to the detection of synovitis but has expanded to detect various extra skeletal manifestations of rheumatological diseases. Absence of radiation hazards, reasonable cost, and widespread availability are the added advantages of USG. In this article the promising role of USG in musculoskeletal diseases has been reviewed.

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Is ultrasound changing the way we understand rheumatology? Including ultrasound examination in the classification criteria of polymyalgia rheumatica and gout.

Cited by 9 publications

References 50 publications

An optimal ultrasonographic diagnostic test for early gout: A prospective controlled study

An optimal ultrasonographic diagnostic test for early gout: A prospective controlled study

Rola ultrasonografii w diagnostyce chorób reumatycznych w świetle wytycznych ACR/EULAR

Ultrasound in musculoskeletal disorder – A new horizon in rheumatology

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