Abstract
ObjectivesTo identify and synthesize the evidence for the use and measurement properties of musculoskeletal ultrasound in assessing structural joint damage in patients with rheumatoid arthritis (RA). MethodsA systematic literature search (SLR) of the PubMed, Embase and Cochrane Library was performed. Original articles were included published in English reporting on ultrasound of bone erosion, cartilage damage and the measurement properties of ultrasound according to the OMERACT filter 2.1. ResultsOf the 1.495 identified articles 149 were included in the final review, most of which reported on cross-sectional studies and used the OMERACT definitions for ultrasonographic pathology. Among these, bone erosions were assessed in 139 (93.3%), cartilage damage in 24 (16.1%), enthesophytes in 8 (5.4%), osteophytes in 15 (10.1%) and malalignment and ankylosis in a single (0.9%) study, respectively. Most studies (126/149, 84.6%) assessed the joints of the hands. The overwhelming majority of studies (127/149, 85.2%) assessed structural joint damage bilaterally. Validity, reliability and responsiveness were assessed in 21 (14.1%), 34 (22.8%) and 17 (11.4%) studies, respectively. ConclusionWhile the results of this SLR suggest that ultrasound is a sensitive, reliable and feasible tool to detect damage in RA, they also highlight the need for further research and validation. Findings of this SLR will inform the next steps of the OMERACT Ultrasound Working Group in developing an ultrasound score for assessing structural joint damage in patients with RA.
Highlights
Diagnosis is the key to a successful therapy in rheumatoid arthritis (RA) and to prevent the progression of structural damage in synovial joints [1]
One of the major advantages of ultrasound is its capability to visualize and quantify synovitis, which is predictive of structural damage
In contrast to the utility of ultrasound in evaluating inflammatory activity expressed by synovitis, much less has been published regarding the sonographic assessment of structural damage in RA
Summary
Diagnosis is the key to a successful therapy in rheumatoid arthritis (RA) and to prevent the progression of structural damage in synovial joints [1]. Joint damage in RA includes, among others loss of hyaline cartilage [2] and bone erosions [3]. The detection of these two components is crucial for diagnosis and for monitoring of therapeutic targets [4]. I. Gessl et al / Seminars in Arthritis and Rheumatism 51 (2021) 627À639 tomography (CT) have been reported as sensitive and reliable alternatives to detect both cartilage damage [2,12] and bone erosions [3,13]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
