Power Doppler ultrasound in musculoskeletal disease: a systematic review.
OBJECTIVE
To evaluate the performance characteristics of power Doppler ultrasound as a diagnostic and monitoring tool in the assessment of musculoskeletal disease through a systematic review of the literature.


METHODS



METHODS
We performed a literature search of PUBMED (1966 to June 2005).


METHODS
Only original research reports written in English involving musculoskeletal disease and power Doppler ultrasound were included. Reviews were noted but not included. Data Extraction/Reporting: The design, subjects, methods, imaging protocols, and performance characteristics studied in the research papers were reported.


RESULTS
Of 3568 identified reports, 139 involved power Doppler ultrasound of the musculoskeletal system. Fifty-three of these reports met the inclusion criteria. Ultrasound machine settings were specified in 63% of reports. Rheumatoid arthritis was the most commonly studied musculoskeletal disease (64% of papers). Validity was the most studied performance characteristic (94% of reports), while reliability and responsiveness were studied in 17 and 34%, respectively.


CONCLUSIONS
Although the majority of research reports of power Doppler ultrasound assessment of the musculoskeletal system evaluated validity, less than half reported reliability and responsiveness. Further work is needed to evaluate power Doppler ultrasound assessment of the musculoskeletal system before it can be used to guide clinical decisions or be used as an endpoint in clinical trials.
Joshua
Fredrick
F
Rheumatology Department, St. George Hospital, Kogarah, NSW, Australia. fredjoshua@bigpond.com
Edmonds
John
J
Lassere
Marissa
M
D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging*; D006801:Humans; D009140:Musculoskeletal Diseases / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000592:standards