title: Ultrasonography in the diagnosis and management of patients with inflammatory arthritides.
abstract: In primary care and internal medicine settings clinicians are often reluctant to take advantage of the resources that ultrasonography (US) offers as a diagnostic tool in the initial management of patients with inflammatory arthritis, despite the recognised importance of an accurate and timely diagnosis of rheumatoid arthritis (RA) and of early referral to ensure optimal patient management. Both grey-scale (GS) and power Doppler (PD) imaging have been extensively used in early detection of synovitis and bone erosions in patients with inflammatory arthritides. We reviewed the main data on the clinical use of US in the initial management of patients with inflammatory arthritis, focusing on RA diagnosis in patients with undifferentiated arthritis, prediction of disease severity, differential diagnoses and assessment of synovitis in children with juvenile idiopathic arthritis (JIA). The role of US in assessing treatment response and monitoring disease activity in clinical remission was also briefly evaluated. The reliability of US as a diagnostic tool in rheumatological diseases has greatly advanced in the last years and the use of this imaging technique, in association with conventional assessments such as physical examination and serological tests, should be considered more often also in primary care settings.
authors.affiliation: S.C. Reumatologia, A.O. Ospedale Niguarda Ca' Granda, Milano, Italy. Electronic address: oscar.epis@ospedaleniguarda.it.
authors.forename: Oscar
authors.initials: O
authors.lastname: Epis
authors.affiliation: U.O. Reumatologia, Ospedale 'S. Francesco Caracciolo', Agnone, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Paoletti
authors.affiliation: Ambulatiorio di Reumatologia, P.O. 'S.M.d.P degli Incurabili', Napoli, Italy.
authors.forename: Tito
authors.initials: T
authors.lastname: d'Errico
authors.affiliation: Divisione di Reumatologia, Istituto Ortopedico G. Pini, Milano, Italy.
authors.forename: Ennio
authors.initials: E
authors.lastname: Favalli
authors.affiliation: Struttura Complessa di Reumatologia, A.O.U. Cagliari, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Garau
authors.affiliation: Istituto Ortopedico Rizzoli, U.O. Reumatologia, Bologna, Italy.
authors.forename: Luana
authors.initials: L
authors.lastname: Mancarella
authors.affiliation: Clinica Medica, A.O.U. Ospedali Riuniti, Ancona, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pomponio
authors.affiliation: Dipartimento di Medicina Diagnostica, Clinica e di Sanità Pubblica, Università degli Studi di Modena e Reggio Emilia, Italy.
authors.forename: Gilda
authors.initials: G
authors.lastname: Sandri
authors.affiliation: Sezione di Reumatologia, Università degli Studi 'Aldo Moro', Bari, Italy.
authors.forename: Crescenzio
authors.initials: C
authors.lastname: Scioscia
authors.affiliation: Sezione di Reumatologia, A.O.U. Senese, Siena, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Selvi
authors.affiliation: U.O. Reumatologia, Ospedale 'S. Giovanni Bosco', Napoli, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Tirri
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use; D001168:Arthritis / Q000000981:diagnostic imaging / Q000188:drug therapy; D001171:Arthritis, Juvenile / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D019468:Disease Management; D006801:Humans; D012720:Severity of Illness Index; D013585:Synovitis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D018608:Ultrasonography, Doppler; D018615:Ultrasonography, Doppler, Color
chemical_list: D018501:Antirheumatic Agents
keywords: Diagnosis; Inflammatory arthritis; Rheumatoid arthritis; Ultrasonography