The use of musculoskeletal ultrasound of the wrist and hand in the assessment of treatment response in rheumatoid arthritis patients

Citation:
A N, GO O, C O. "The use of musculoskeletal ultrasound of the wrist and hand in the assessment of treatment response in rheumatoid arthritis patients." Afr J Rheumatol. 2020;8(1):3-7.

Abstract:

Objective: Rheumatoid arthritis is a
debilitating disease with accrual of joint damage during each flare of the disease that progresses to considerable functional disability. Early treatment is
thus aimed to achieve remission status so as to reduce the progression of joint
damage. Currently the disease activity parameter DAS28 (amongst others)
is used to define a remission status and thus demonstrate the efficacy
of a treatment regimen, however musculoskeletal ultrasound (MSUS) is
proving to be superior at determining the amount of inflammation within joints by grading synovial hypertrophy and neo-vascularization of the
inflamed synovium. This article is thus intended to shed light on the usefulness of musculoskeletal ultrasound
both greyscale and Doppler in the determination of treatment response
in rheumatoid arthritis patients. Design: This article will elaborate
the importance and effectiveness of musculoskeletal ultrasound. Thus it will involve a discussion on the need for an effective tool to detect inflammatory activity, the ability of ultrasound to detect and grade the disease activity i.e.
being sensitive to change, the various scoring systems currently used, and
lastly a comparison of musculoskeletal ultrasound to other modalities and
clinical and serological evaluation. Data source and extraction:
Published studies, reviews and guidelines regarding the use of
musculoskeletal ultrasound of the wrist/hand in assessing treatment
response in rheumatoid arthritis patients were sourced through the
internet and library searches and the relevant data extracted. Conclusion:
status of the patient or a high initial ESR with significant serological and clinical
improvement, which will again not be portrayed in the DAS28 results. There may also be variability when assessing joints that are swollen or tender in between different examiners4. Moreover, there is a subset of
patients who still have disease progression despite achieving clinical remission status5.
  Magnetic Resonance Imaging (MRI) and radiographic evaluation have also been used as adjuncts to clinical exam but both have their drawb

UoN Websites Search