The role of Doppler ultrasound in rheumatic diseases

Abstract

The use of Doppler techniques, including power, colour and spectral Doppler, has greatly increased in rheumatology in recent years. This is due to the ability of Doppler US (DUS) to detect pathological vascularization within joints and periarticular soft tissues, thereby demonstrating the presence of active inflammation, which has been reported to be correlated with the local neo-angiogenesis. In synovitis, DUS showed a high correlation with histological and MRI findings, thus it is considered a valid tool to detect pathological synovial vascularization. Moreover, it is more sensitive than clinical examination in detecting active joint inflammation and in the evaluation of response to treatment. In addition, DUS may be considered as a reference imaging modality in the assessment of enthesitis, MRI being not sensitive and histology not feasible. Moreover, it has been demonstrated to be able to detect changes in asymptomatic enthesis. In conclusion, DUS is a useful and sensitive tool in the evaluation and monitoring of active inflammation. Its widespread use in clinical rheumatological practice is recommended. The aim of this article is to review the current literature about the role of DUS in rheumatic diseases, analysing its validity, reliability and feasibility.

Strongly positive anti‐CCP antibodies in patients with sacroiliitis or reactive arthritis post‐E. coli infection: A mini case‐series based review

“…for assessing active inflammatory changes in RA, 17 while MRI is included in the classification criteria for SpAs. 18 The presence of anti-CCP is of particular importance in RA due to its high specificity and its use as a prognostic factor for joint erosion and disease progression.…”

Concepts in diagnosing, scoring, and monitoring tenosynovitis and other tendon abnormalities in patients with rheumatoid arthritis- the role of musculoskeletal ultrasound.

“…Currently, available evidence supports the important contribution of several high resolution imaging methods in identifying joint, peri-articular, and erosive changes at any point during the disease course. Musculoskeletal ultrasound (MSUS) has already proven its utility for directly visualization of the joint synovial tissue (morphology and quantification), the synovial vascularization (presence and quantification), and in monitoring the response to therapy [18][19][20][21][22][23][24][25][26][27]. Recently, much attention has been given to the presence of tenosynovitis, as a constant, complementary, but different facet of the inflammatory involvement in RA [28][29][30].…”

Concepts in monitoring the treatment in rheumatoid arthritis – the role of musculoskeletal ultrasound. Part I: synovitis.

“…Doppler techniques such as power Doppler (PD), color Doppler (CD), and spectral Doppler identify in real time the increased synovial micro-vascular blood flow. These parameters correlate with the level of disease activity at one given point in time [42][43][44][45][46][47]. Apart from GS and Doppler assessment of different structures, MSUS shows several other advantages such as high accessibility (it is routinely used in many rheumatology departments in and out-patient clinics), low cost in comparison to MRI, CT, and safety-i.e.…”