Use and scope of ultrasonography in rheumatology in India

Abstract

Musculoskeletal ultrasound (MSUS), once a sole territory of radiologists, has over the past decade been increasingly exploited by rheumatologists in clinical practice and as a research tool. Technical expansion in the field of ultrasonography has made MSUS a powerful tool in the early identification of inflammatory and noninflammatory rheumatic disease, monitoring disease, predicting therapeutic responses and guidance for procedures such as diagnostic fluid aspiration and peri- or intra-lesional therapeutic injections. US can be performed readily in the clinic, with an assessment of multiple joints at the same appointment, providing a “one-stop” answer to many MS problems. MSUS is widely accepted as an adjunct to clinical examination among rheumatologists in Europe and is rapidly gaining acceptance in the United States. In India, US is under the purview of the preconception and prenatal diagnostics techniques Act, which does not acknowledge the multiple role of point-of-care ultrasonography. There are some other critical issues of equipment costs, training and certification and the relationship of rheumatologists and radiologists in advancing the field of MSUS in India.