Abstract
Several studies have emphasized the role of ultrasonography in the management of rheumatoid arthritis. It has shown its interest in the diagnosis of the disease. This imaging modality is more sensitive than clinical examination, allowing a detection of subclinical synovitis and therefore and earlier diagnosis and treatment. Treating patient in this “window of opportunity” is associated with a better long-term prognosis. Some US features, specific of other inflammatory rheumatisms (psoriatic arthritis, crystal arthropathies…), will help in the differential diagnosis of early-undifferentiated arthritis. Ultrasound is also useful in guiding treatment decisions, monitoring disease activity and guiding joint injections. In this context, Doppler signal positivity is associated with future structural damages and predicts relapses inpatient in clinical remission. Achievement of imaging remission might be the next step in the management of RA. However, it remains controversial whether US-defined remission improves patient outcomes and more studies are needed to answer this question.
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