title: Role of ultrasound in assessing remission in rheumatoid arthritis.
abstract: BACKGROUND
  Remission is the ultimate goal of the treatment of rheumatoid arthritis (RA). However, the diagnosis of remission might still be vague. Musculoskeletal ultrasound (US) seems to effectively assess synovitis, effusion and bone damage. Thus, its role could be relevant for the diagnosis, monitoring or detection of relapse in the follow-up of RA in remission. The goal of this review of the literature was to clarify the added value of ultrasonography during remission.
  
  
  METHODS
  A systemic search of the literature was performed on Medline and Scopus. The following key words were used: rheumatoid arthritis, remission, US. Fifty-six papers were collected, then after an in depth analysis, twelve articles were selected for analysis.
  
  
  RESULTS
  Twelve papers were identified that assessed remission in RA. Remission criteria varied from one author to another. The number of joints assessed by US varied from six to 44 with the wrist and metacarpo-phalangeal joints of the dominant hand scanned at least. Irrespective of remission criteria, all authors demonstrated that US detected Doppler positive synovitis in patients in clinical remission. Also, power Doppler synovitis predicted structural damage and future flares of RA.
  
  
  CONCLUSIONS
  US seems to be more effective than a clinical exam. True remission in RA must be defined. Moreover, the inclusion of this technique in the new definition of remission is being validated.
authors.affiliation: Rheumatology department, Mongi Slim hospital, la Marsa, Tunisia.
authors.forename: K
authors.initials: K
authors.lastname: Ben Abdelghani
authors.affiliation: Rheumatology department, Mongi Slim hospital, la Marsa, Tunisia. Electronic address: saoussenmld@hotmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Miladi
authors.affiliation: Rheumatology department, Mongi Slim hospital, la Marsa, Tunisia.
authors.forename: L
authors.initials: L
authors.lastname: Souabni
authors.affiliation: Rheumatology department, Mongi Slim hospital, la Marsa, Tunisia.
authors.forename: S
authors.initials: S
authors.lastname: Kassab
authors.affiliation: Rheumatology department, Mongi Slim hospital, la Marsa, Tunisia.
authors.forename: S
authors.initials: S
authors.lastname: Chekili
authors.affiliation: Rheumatology department, Mongi Slim hospital, la Marsa, Tunisia.
authors.forename: A
authors.initials: A
authors.lastname: Laatar
authors.affiliation: Rheumatology department, Mongi Slim hospital, la Marsa, Tunisia.
authors.forename: L
authors.initials: L
authors.lastname: Zakraoui
mesh_terms: D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging*; D006801:Humans; D011237:Predictive Value of Tests; D012074:Remission Induction; D014463:Ultrasonography
keywords: Remission; Rheumatoid arthritis; Ultrasound