The value of contrast-enhanced musculoskeletal ultrasound for early diagnosis, monitoring of disease activity and assessment of treatment efficacy in patients with rheumatoid arthritis and psoriatic arthritis

Abstract

Rheumatoid arthritis (RA) and Psoriatic arthritis (PsA) are the most common autoimmune inflammatory joint diseases. The prevalence of RA is at 0,5-1%. The main clinical manifestation of RA is symmetric progressive erosive polyarthtitis. PsA is inflammatory arthritis associated with skin psoriasis. The prevalence of PsA in general population vary from 0,3% to 1%. The disease has heterogeneous clinical features – joint involvement, tenosynovitis, enthesitis, dactylitis, nail changes, eyes disorders, skin lesions. Most patients, at 70-80% of cases, present with asymmetric mono- or oligoarthritis. Both RA and PsA are chronic inflammatory joint disorders which may cause severe structural joint changes and functional deficiency of patients. They have a significant medical and social importance. Within the past two decades musculoskeletal ultrasound (MUS) has become an essential diagnostic method for evaluation of musculoskeletal diseases with ultrasound imaging. MUS is accessible, non-invasive technique which can provide precise information about pathological changes occurring in all articular and periarticular structures in patients with RA and PsA. Advances in technology together with the usage of higher frequency transducers, the possibilities of color/ power Doppler imaging, the implementation of ultrasound contrast agent, have contributed to the progressive development of the methodology. The purpose of this review is to perform the value of contrast-enhanced musculoskeletal ultrasound (CEUS) for early diagnosis, monitoring of disease activity and assessment of treatment efficacy in patients with rheumatoid arthritis and psoriatic arthritis.