Ultrasound Sees Rheumatic Disease

Rheumatologists are embracing ultrasound for diagnosis and management of rheumatic diseases

(RxWiki News) Doctors often use imaging tests to diagnose and keep track of arthritis. One of these imaging tests is becoming more favored by doctors. In response, experts have made recommendations for the best use of the test.

The American College of Rheumatology put together a task force to study when it would be best to use musculoskeletal ultrasound (MSUS) - a test that uses sound waves to make images - to diagnose and treat rheumatic diseases like rheumatoid arthritis and lupus.

If doctors know how to properly use this tool, patients may have a better chance of an accurate diagnosis. In addition, proper use of MSUS may give doctors a better picture of whether treatment is working for their patients.

"See your doctor regularly."

According to the American College of Rheumatology, an estimated 50 million people in the United States are affected by arthritis. Another seven million Americans are affected by some form of inflammatory rheumatic disease like lupus or gout.

"With so many people affected by rheumatic diseases, including arthritis, a diagnostic tool such as MSUS that is minimally invasive and with little risk to patients is an important tool for rheumatologists," said Tim McAlindon, MD, MPH, of Tufts University.

"Our task force goal was to establish when use of MSUS was 'reasonable' in a number of medical situations," he said.

According to a press release from Wiley - the publisher of the journal where the recommendations appear - using MSUS in the right situations could lead to a faster and more accurate diagnosis. Proper use of MSUS could also lead to better measurement of treatment success, less pain from testing procedures and higher patient satisfaction.

Through reviewing studies on the topic, Dr. McAlindon and colleagues put together recommendations for how MSUS could be used in the doctor's office.

Each recommendation was based on evidence and rated by the quality of that evidence.

Some of the recommendations included:

  • For patients with joint pain, swelling and function problems and without a definitive diagnosis, it is reasonable to use MSUS to clear up diagnosis of the following joints: shoulders, elbow, wrist, finger joints, hip, knee, ankle, midfoot and toes among others.
  • For patients with shoulder pain or function problems and without a definitive diagnosis, it is reasonable to use MSUS to assess structural problems. However, it is not reasonable to use MSUS to assess frozen shoulder (when a painful shoulder loses motion due to inflammation) or to prepare for surgery.
  • It is reasonable to use MSUS to look for certain signs of Sjögren's syndrome.

The above list includes only three of the 14 recommendations made by the task force. The full list is available in the research article - which was published October 30 in Arthritis Care & Research, a journal of the American College of Rheumatology.

Some of the task force members disclosed receiving fees or working for Flexion Therapeutics, URL Pharma, Novartis, Bioiberica, Sonosite, The Journal of Ultrasound Medicine, Celgene, Roche and Abbott.

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Review Date: 
October 30, 2012