The changing role of ultrasonography examination in patients with rheumatoid arthritis in light of recent studies

Abstract

For many years, ultrasonography (US) has been a widely accepted modality used for joint assessment in patients with rheumatoid arthritis (RA). Given the efficacy of present day therapies, there is scepticism whether it is required in the first place. The most recent clinical Targeting synovitis in Early Rheumatoid Arthritis (TaSER) and Clinical Tight Control Therapy (ARCTIC) trials' results appear to contradict it, yet this does not necessarily mean ultrasound has no place in modern rheumatology. The possibility of detecting inflammation at a subclinical level carries a tremendous predictive value, enabling identification of patients likely to experience an exacerbation in the coming months. Therefore, US should be a part of the decision-making process regarding treatment modification or introduction of any additional interventions, such as glucocorticosteroid injections. The results of the most recent clinical trials do not negate the usefulness of US, but merely suggest that it ought to be used in moderation.

Dual-energy computed tomography — possible applications in the diagnosis of rheumatic diseases

“…In inflammatory joint diseases (IJDs), ultrasound (US) and magnetic resonance imaging (MRI) play a much more important role among imaging tests. They make it possible to assess the presence of inflammation within the joints and especially within the synovial membrane (synovitis) and the tendon-muscle attachments (enthesitis), currently considered to be the most important in the pathogenesis of inflammatory diseases of the joints and spine [2]. It is the presence of inflammation that is associated with both increased disease activity and the risk of progression of radiological changes.…”

“…9, No. 4: 182-185 KEY WORDS: dual-energy computed tomography; ultrasonography; magnetic resonance er hand, the absence of inflammation within the joints is indicative of the efficacy of ongoing therapy and the achievement of remission [2]. From the point of view of clinical practice, US and MRI are extremely important in the diagnostic process.…”