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Musculoskeletal ultrasound and other imaging modalities in rheumatoid arthritis

Ohrndorf, Saraha; Werner, Stephanie G.a; Finzel, Stephanieb; Backhaus, Marinaa

Current Opinion in Rheumatology: May 2013 - Volume 25 - Issue 3 - p 367–374
doi: 10.1097/BOR.0b013e32835fad45
RHEUMATOID ARTHRITIS: Edited by Ronald F. van Vollenhoven

Purpose of review This review refers to the use of musculoskeletal ultrasound in patients with rheumatoid arthritis (RA) both in clinical practice and research. Furthermore, other novel sensitive imaging modalities (high resolution peripheral quantitative computed tomography and fluorescence optical imaging) are introduced in this article.

Recent findings Recently published ultrasound studies presented power Doppler activity by ultrasound highly predictive for later radiographic erosions in patients with RA. Another study presented synovitis detected by ultrasound being predictive of subsequent structural radiographic destruction irrespective of the ultrasound modality (grayscale ultrasound/power Doppler ultrasound). Further studies are currently under way which prove ultrasound findings as imaging biomarkers in the destructive process of RA. Other introduced novel imaging modalities are in the validation process to prove their impact and significance in inflammatory joint diseases.

Summary The introduced imaging modalities show different sensitivities and specificities as well as strength and weakness belonging to the assessment of inflammation, differentiation of the involved structures and radiological progression. The review tries to give an answer regarding how to best integrate them into daily clinical practice with the aim to improve the diagnostic algorithms, the daily patient care and, furthermore, the disease's outcome.

aDepartment of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Berlin

bDepartment of Internal Medicine 3, Rheumatology and Immunology, University Clinic of Erlangen, Erlangen, Germany

Correspondence to Marina Backhaus, MD, Professor of Rheumatology, Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, D-10117 Berlin, Germany. Tel: +49 30 450 513 137; fax: +49 30 450 513 939; e-mail:

© 2013 Lippincott Williams & Wilkins, Inc.