Can a Targeted Ultrasound Initiative Improve RA Outcomes?
Imaging techniques such as ultrasound and MRI have the capability to directly visualise both synovitis and bone damage. Both have recently become more readily accessible to clinicians and applied for use in RA. Each has their own advantages and disadvantages, although on a practical level, ultrasound is less expensive, easily repeatable, able to be delivered at the point of care and can be more feasibly used to assess multiple joint areas at one sitting. The relevant MR papers are referenced.
Ultrasound can be used to assess two aspects of synovitis: its morphology and quantity using grey scale (GS) and synovial vascularity as measured by colour or power Doppler (PD). It is the latter component that has attracted particular attention as this has been shown to better correlate with inflammatory activity than GS alone.
The aim of this paper is to reflect on recent published data relating to the utility of ultrasound in defining and determining remission in RA patients and to present the outline of a newly planned study attempting to determine the significance of subclinical synovitis. A summary of the key papers relating to ultrasound and remission is given in Table 1.
Imaging and Remission
Imaging techniques such as ultrasound and MRI have the capability to directly visualise both synovitis and bone damage. Both have recently become more readily accessible to clinicians and applied for use in RA. Each has their own advantages and disadvantages, although on a practical level, ultrasound is less expensive, easily repeatable, able to be delivered at the point of care and can be more feasibly used to assess multiple joint areas at one sitting. The relevant MR papers are referenced.
Ultrasound can be used to assess two aspects of synovitis: its morphology and quantity using grey scale (GS) and synovial vascularity as measured by colour or power Doppler (PD). It is the latter component that has attracted particular attention as this has been shown to better correlate with inflammatory activity than GS alone.
The aim of this paper is to reflect on recent published data relating to the utility of ultrasound in defining and determining remission in RA patients and to present the outline of a newly planned study attempting to determine the significance of subclinical synovitis. A summary of the key papers relating to ultrasound and remission is given in Table 1.
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