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Yıl 2025, Cilt: 7 Sayı: 3, 795 - 8, 09.09.2025
https://doi.org/10.37990/medr.1615159
https://izlik.org/JA64LY97ST

Öz

Kaynakça

  • Forien M, Ottaviani S. Ultrasound and follow-up of rheumatoid arthritis. Jt Bone Spine. 2017;84:531-6.
  • Levitsky A, Kisten Y, Lind S, et al. Joint mobilization of the hands of patients with rheumatoid arthritis: results from an assessor-blinded, randomized crossover trial. J Manipulative Physiol Ther. 2019;42:34-46.
  • Bhasin S, Cheung PP. The role of power Doppler ultrasonography as disease activity marker in rheumatoid arthritis. Dis Markers. 2015;2015:325909.
  • Toprak H, Kiliç E, Serter A, et al. Doppler US in rheumatic diseases with special emphasis on rheumatoid arthritis and spondyloarthritis. Diagnostic Interv Radiol. 2014;20:72-7.
  • Andersen M, Ellegaard K, Hebsgaard JB, et al. Ultrasound colour Doppler is associated with synovial pathology in biopsies from hand joints in rheumatoid arthritis patients: a cross-sectional study. Ann Rheum Dis. 2014;73:678-83.
  • Rezaei H, Torp-Pedersen S, Klint EAF, et al. Diagnostic utility of musculoskeletal ultrasound in patients with suspected arthritis - a probabilistic approach. Arthritis Res Ther. 2014;16:448.
  • Szkudlarek M, Court-Payen M, Jacobsen S, et al. Interobserver agreement in ultrasonography of the finger and toe joints in rheumatoid arthritis. Arthritis Rheum. 2003;48:955-62.
  • Dejaco C, Machado PM, Carubbi F, et al. EULAR points to consider for the use of imaging to guide interventional procedures in patients with rheumatic and musculoskeletal diseases (RMDs). Ann Rheum Dis. 2022;81:760-7.
  • Filippucci E, Salaffi F, Carotti M, Grassi W. Doppler ultrasound imaging techniques for assessment of synovial inflammation. Reports Med Imaging. 2013;6:83-91.
  • D’Agostino MA, Terslev L, Aegerter P, et al. Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce - Part 1: definition and development of a standardised, consensus-based scoring system. RMD Open. 2017;3:e000428.
  • Merritt CRB. Doppler color flow imaging. J Clin ultrasound. 1987;15:591-7.
  • Terslev L, Torp-Pedersen S, Qvistgaard E, et al. Doppler ultrasound findings in healthy wrists and finger joints. Ann Rheum Dis. 2004;63:644-8.
  • Koski JM, Saarakkala S, Helle M, et al. Power Doppler ultrasonography and synovitis: correlating ultrasound imaging with histopathological findings and evaluating the performance of ultrasound equipments. Ann Rheum Dis. 2006;65:1590-5.
  • Carotti M, Galeazzi V, Catucci F, et al. Clinical utility of eco-color-power Doppler ultrasonography and contrast enhanced magnetic resonance imaging for interpretation and quantification of joint synovitis: a review. Acta Biomed. 2018;89:48-77.
  • Tacelli M, Lauri G, Tabacelia D, et al. Integrating artificial intelligence with endoscopic ultrasound in the early detection of bilio-pancreatic lesions: Current advances and future prospects. Best Pract Res Clin Gastroenterol. 2025;74:101975.
  • Piron CA, Causer P, Jong R, et al. A hybrid breast biopsy system combining ultrasound and MRI. IEEE Trans Med Imaging. 2003;22:1100-10.
  • Sheane BJ, Beddy P, O’Connor M, et al. Targeted ultrasound of the fifth metatarsophalangeal joint in an early inflammatory arthritis cohort. Arthritis Care Res. 2009;61:1004-8.
  • Szkudlarek M, Narvestad E, Klarlund M, et al. Ultrasonography of the metatarsophalangeal joints in rheumatoid arthritis: comparison with magnetic resonance imaging, conventional radiography, and clinical examination. Arthritis Rheum. 2004;50:2103-12.
  • Ruiz Santiago F, Láinez Ramos-Bossini AJ, Wáng YXJ, López Zúñiga D. The role of radiography in the study of spinal disorders. Quant Imaging Med Surg. 2020;10:2322-55.
  • Sankowski AJ, Łebkowska UM, Ćwikła J, et al. The comparison of efficacy of different imaging techniques (conventional radiography, ultrasonography, magnetic resonance) in assessment of wrist joints and metacarpophalangeal joints in patients with psoriatic arthritis. Polish J Radiol. 2013;78:18-29.
  • Østergaard M, Ejbjerg B, Szkudlarek M. Imaging in early rheumatoid arthritis: roles of magnetic resonance imaging, ultrasonography, conventional radiography and computed tomography. Best Pract Res Clin Rheumatol. 2005;19:91-116.
  • Terslev L, Naredo E, Aegerter P, et al. Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce-Part 2: reliability and application to multiple joints of a standardised consensus-based scoring system. RMD Open. 2017;3:e000427.
  • Mandl P, Naredo E, Wakefield RJ, et al. A systematic literature review analysis of ultrasound joint count and scoring systems to assess synovitis in rheumatoid arthritis according to the OMERACT filter. J Rheumatol. 2011;38:2055-62.

Limitations of Diagnostic Ultrasound Use in Rheumatoid Arthritis Rehabilitation: Technical Report

Yıl 2025, Cilt: 7 Sayı: 3, 795 - 8, 09.09.2025
https://doi.org/10.37990/medr.1615159
https://izlik.org/JA64LY97ST

Öz

Aim: The purpose of this technical note is to critically evaluate the role of ultrasound in the diagnosis and management of rheumatoid arthritis (RA).
Material and Method: In this study joint distance, effusion area and degree of inflammation were assessed using the GE Color Doppler device. Participants diagnosed with RA are positioned comfortably and the area under examination is completely relaxed.
Results: The primary constraint on the utilisation of ultrasound imaging in the management of RA pertains to the necessity for expertise and experience on the part of the ultrasonographer. In addition, the imaging capacity to visualise deep structures is inadequate, a problem that is exacerbated in obese patients due to inadequate penetration. Thirdly, ultrasound (US) exhibits lower resolution compared to alternative imaging modalities such as Magnetic Resonance Imaging (MRI), resulting in its inability to distinguish subtle bone changes. The fourth limitation relates to the difficulties associated with imaging small joints, such as the hands, due to their size and anatomical complexity. Finally, the effectiveness of ultrasound in identifying synovial thickening and erosions is well documented; however, its inability to differentiate between active inflammation and chronic fibrotic changes may hinder treatment decisions in some cases.
Conclusion: Ultrasound is a valuable tool in managing RA, but its effectiveness is limited by operator dependency, imaging challenges, and difficulty distinguishing active inflammation from chronic changes. Enhancing training, standardizing protocols, and integrating advanced technologies like artificial intelligence (AI) and hybrid imaging can improve its diagnostic precision and utility in rheumatological care.

Etik Beyan

Ethical approval of the study was obtained from Haliç University Non-Interventional Studies Ethics Committee with the number 2023/64. Voluntary consent form was signed by the participants (date: 28.03.2023).

Kaynakça

  • Forien M, Ottaviani S. Ultrasound and follow-up of rheumatoid arthritis. Jt Bone Spine. 2017;84:531-6.
  • Levitsky A, Kisten Y, Lind S, et al. Joint mobilization of the hands of patients with rheumatoid arthritis: results from an assessor-blinded, randomized crossover trial. J Manipulative Physiol Ther. 2019;42:34-46.
  • Bhasin S, Cheung PP. The role of power Doppler ultrasonography as disease activity marker in rheumatoid arthritis. Dis Markers. 2015;2015:325909.
  • Toprak H, Kiliç E, Serter A, et al. Doppler US in rheumatic diseases with special emphasis on rheumatoid arthritis and spondyloarthritis. Diagnostic Interv Radiol. 2014;20:72-7.
  • Andersen M, Ellegaard K, Hebsgaard JB, et al. Ultrasound colour Doppler is associated with synovial pathology in biopsies from hand joints in rheumatoid arthritis patients: a cross-sectional study. Ann Rheum Dis. 2014;73:678-83.
  • Rezaei H, Torp-Pedersen S, Klint EAF, et al. Diagnostic utility of musculoskeletal ultrasound in patients with suspected arthritis - a probabilistic approach. Arthritis Res Ther. 2014;16:448.
  • Szkudlarek M, Court-Payen M, Jacobsen S, et al. Interobserver agreement in ultrasonography of the finger and toe joints in rheumatoid arthritis. Arthritis Rheum. 2003;48:955-62.
  • Dejaco C, Machado PM, Carubbi F, et al. EULAR points to consider for the use of imaging to guide interventional procedures in patients with rheumatic and musculoskeletal diseases (RMDs). Ann Rheum Dis. 2022;81:760-7.
  • Filippucci E, Salaffi F, Carotti M, Grassi W. Doppler ultrasound imaging techniques for assessment of synovial inflammation. Reports Med Imaging. 2013;6:83-91.
  • D’Agostino MA, Terslev L, Aegerter P, et al. Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce - Part 1: definition and development of a standardised, consensus-based scoring system. RMD Open. 2017;3:e000428.
  • Merritt CRB. Doppler color flow imaging. J Clin ultrasound. 1987;15:591-7.
  • Terslev L, Torp-Pedersen S, Qvistgaard E, et al. Doppler ultrasound findings in healthy wrists and finger joints. Ann Rheum Dis. 2004;63:644-8.
  • Koski JM, Saarakkala S, Helle M, et al. Power Doppler ultrasonography and synovitis: correlating ultrasound imaging with histopathological findings and evaluating the performance of ultrasound equipments. Ann Rheum Dis. 2006;65:1590-5.
  • Carotti M, Galeazzi V, Catucci F, et al. Clinical utility of eco-color-power Doppler ultrasonography and contrast enhanced magnetic resonance imaging for interpretation and quantification of joint synovitis: a review. Acta Biomed. 2018;89:48-77.
  • Tacelli M, Lauri G, Tabacelia D, et al. Integrating artificial intelligence with endoscopic ultrasound in the early detection of bilio-pancreatic lesions: Current advances and future prospects. Best Pract Res Clin Gastroenterol. 2025;74:101975.
  • Piron CA, Causer P, Jong R, et al. A hybrid breast biopsy system combining ultrasound and MRI. IEEE Trans Med Imaging. 2003;22:1100-10.
  • Sheane BJ, Beddy P, O’Connor M, et al. Targeted ultrasound of the fifth metatarsophalangeal joint in an early inflammatory arthritis cohort. Arthritis Care Res. 2009;61:1004-8.
  • Szkudlarek M, Narvestad E, Klarlund M, et al. Ultrasonography of the metatarsophalangeal joints in rheumatoid arthritis: comparison with magnetic resonance imaging, conventional radiography, and clinical examination. Arthritis Rheum. 2004;50:2103-12.
  • Ruiz Santiago F, Láinez Ramos-Bossini AJ, Wáng YXJ, López Zúñiga D. The role of radiography in the study of spinal disorders. Quant Imaging Med Surg. 2020;10:2322-55.
  • Sankowski AJ, Łebkowska UM, Ćwikła J, et al. The comparison of efficacy of different imaging techniques (conventional radiography, ultrasonography, magnetic resonance) in assessment of wrist joints and metacarpophalangeal joints in patients with psoriatic arthritis. Polish J Radiol. 2013;78:18-29.
  • Østergaard M, Ejbjerg B, Szkudlarek M. Imaging in early rheumatoid arthritis: roles of magnetic resonance imaging, ultrasonography, conventional radiography and computed tomography. Best Pract Res Clin Rheumatol. 2005;19:91-116.
  • Terslev L, Naredo E, Aegerter P, et al. Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce-Part 2: reliability and application to multiple joints of a standardised consensus-based scoring system. RMD Open. 2017;3:e000427.
  • Mandl P, Naredo E, Wakefield RJ, et al. A systematic literature review analysis of ultrasound joint count and scoring systems to assess synovitis in rheumatoid arthritis according to the OMERACT filter. J Rheumatol. 2011;38:2055-62.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Romatoloji ve Artrit
Bölüm Teknik Not
Yazarlar

Ömer Faruk Özçelep 0000-0002-9232-2431

Nur Tunalı 0000-0002-0584-403X

Gönderilme Tarihi 7 Ocak 2025
Kabul Tarihi 4 Şubat 2025
Yayımlanma Tarihi 9 Eylül 2025
DOI https://doi.org/10.37990/medr.1615159
IZ https://izlik.org/JA64LY97ST
Yayımlandığı Sayı Yıl 2025 Cilt: 7 Sayı: 3

Kaynak Göster

AMA 1.Özçelep ÖF, Tunalı N. Limitations of Diagnostic Ultrasound Use in Rheumatoid Arthritis Rehabilitation: Technical Report. Med Records. 2025;7(3):795-8. doi:10.37990/medr.1615159

Chief Editors
Prof. Dr. Berkant Özpolat, MD
Department of Thoracic Surgery, Ufuk University, Dr. Rıdvan Ege Hospital, Ankara, Türkiye

Editors
Prof. Dr. Sercan Okutucu, MD
Department of Cardiology, Ankara Lokman Hekim University, Ankara, Türkiye

Assoc. Prof. Dr. Süleyman Cebeci, MD
Department of Ear, Nose and Throat Diseases, Gazi University Faculty of Medicine, Ankara, Türkiye

Field Editors
Assoc. Prof. Dr. Doğan Öztürk, MD
Department of General Surgery, Manisa Özel Sarıkız Hospital, Manisa, Türkiye

Assoc. Prof. Dr. Birsen Doğanay, MD
Department of Cardiology, Ankara Bilkent City Hospital, Ankara, Türkiye

Assoc. Prof. Dr. Sonay Aydın, MD
Department of Radiology, Erzincan Binali Yıldırım University Faculty of Medicine, Erzincan, Türkiye

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PhD, Dr. Evin Mise
Department of Work Psychology, Ankara University, Ayaş Vocational School, Ankara, Türkiye

Dt. Çise Nazım
Department of Periodontology, Dr. Burhan Nalbantoğlu State Hospital, Lefkoşa, North Cyprus

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Department of Statistics, Hacettepe University, Faculty of Science, Ankara, Türkiye

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