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Role of ultrasonography in the diagnosis of rheumatic diseases in light of ACR/EULAR guidelines.

Płaza M, Nowakowska-Płaza A, Pracoń G, Sudoł-Szopińska I - J Ultrason (2016)

Bottom Line: These criteria have become the basis for recommendations prepared by experts from the European League Against Rheumatism concerning medical imaging in rheumatoid arthritis.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.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.

ABSTRACT
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.

No MeSH data available.


Related in: MedlinePlus

US of the wrist: synovial hypertrophy with poorly enhanced synovial vascularity in the distal radioulnar joint (synovitis)
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Figure 0002: US of the wrist: synovial hypertrophy with poorly enhanced synovial vascularity in the distal radioulnar joint (synovitis)

Mentions: In 2012, new diagnostic criteria were established which have completely changed the attitude to this disease entity (Tab. 2). It was demonstrated that PMR is an inflammatory disease of the neck, shoulders and hips. The role of ultrasound in the imaging of affected structures was emphasized, particularly in the context of poorly severe inflammation in clinical examination. The previous diagnostic criteria were based on a 6-score clinical scale. The new criteria include the clinical picture and an 8-score ultrasound scale. They enable PMR to be differentiated from non-inflammatory pathology of the shoulder and hip, such as post-traumatic changes, overload pathology or degenerative lesions, which frequently are asymmetrical. However, this disease entity cannot be differentiated from RA since the ultrasound image of inflammation that symmetrically affects the joints can be similar. The score of at least 4 of 6 on the scale of these clinical criteria enables the disease to be diagnosed with the sensitivity of 68% and specificity of 78%. However, the score of 5 on the 8-score ultrasound scale allows PMR to be detected with the sensitivity of 81% and specificity of 66%. It seems, therefore, that US plays a particularly important role in the event of doubts(17–19) (Fig. 2).


Role of ultrasonography in the diagnosis of rheumatic diseases in light of ACR/EULAR guidelines.

Płaza M, Nowakowska-Płaza A, Pracoń G, Sudoł-Szopińska I - J Ultrason (2016)

US of the wrist: synovial hypertrophy with poorly enhanced synovial vascularity in the distal radioulnar joint (synovitis)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4834371&req=5

Figure 0002: US of the wrist: synovial hypertrophy with poorly enhanced synovial vascularity in the distal radioulnar joint (synovitis)
Mentions: In 2012, new diagnostic criteria were established which have completely changed the attitude to this disease entity (Tab. 2). It was demonstrated that PMR is an inflammatory disease of the neck, shoulders and hips. The role of ultrasound in the imaging of affected structures was emphasized, particularly in the context of poorly severe inflammation in clinical examination. The previous diagnostic criteria were based on a 6-score clinical scale. The new criteria include the clinical picture and an 8-score ultrasound scale. They enable PMR to be differentiated from non-inflammatory pathology of the shoulder and hip, such as post-traumatic changes, overload pathology or degenerative lesions, which frequently are asymmetrical. However, this disease entity cannot be differentiated from RA since the ultrasound image of inflammation that symmetrically affects the joints can be similar. The score of at least 4 of 6 on the scale of these clinical criteria enables the disease to be diagnosed with the sensitivity of 68% and specificity of 78%. However, the score of 5 on the 8-score ultrasound scale allows PMR to be detected with the sensitivity of 81% and specificity of 66%. It seems, therefore, that US plays a particularly important role in the event of doubts(17–19) (Fig. 2).

Bottom Line: These criteria have become the basis for recommendations prepared by experts from the European League Against Rheumatism concerning medical imaging in rheumatoid arthritis.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.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.

ABSTRACT
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.

No MeSH data available.


Related in: MedlinePlus