Hull York Medical School, University of York, York, UK.
Nat Rev Rheumatol. 2009 Dec;5(12):698-706. doi: 10.1038/nrrheum.2009.227. Epub 2009 Nov 10.
The key to successful management of rheumatoid arthritis (RA) is early objective quantification of inflammation and ongoing precise, tailored therapy to ensure long term suppression of inflammatory disease activity. Musculoskeletal ultrasonography (MSKUS) has emerged as a tool with the potential to enhance disease assessment and management in this area. This includes applications in patients with undifferentiated arthropathy attending an early inflammatory arthritis clinic, in which the diagnosis of inflammatory disease may be confirmed or refuted at an early stage, and those with treated RA where accurate measurement of outcomes, such as response to therapy, structural damage and disease remission, are extremely important. This imaging modality is safe and portable, making it ideal for outpatient and inpatient settings, and can be used to assess many joints in multiple planes and to demonstrate changes in disease activity and structural damage over time. MSKUS is gaining popularity among rheumatologists, as increasing evidence supports the added value of a physician-performed ultrasonography assessment above traditional clinical, laboratory and radiographic measures, enabling greater confidence in diagnostic and management decisions. Although additional longitudinal data are required and further applications are likely to arise, MSKUS may well possess the necessary attributes to facilitate best practice in inflammatory arthritis management.
成功管理类风湿关节炎（RA）的关键在于早期客观量化炎症，并持续进行精确、量身定制的治疗，以确保长期抑制炎症性疾病活动。肌肉骨骼超声（MSKUS）已成为一种具有增强该领域疾病评估和管理潜力的工具。这包括在早期炎症性关节炎诊所就诊的未分化关节炎患者中的应用，在这些患者中，炎症性疾病的诊断可以在早期得到确认或排除，以及在接受治疗的 RA 患者中，对治疗反应、结构损伤和疾病缓解等结果的准确测量非常重要。这种成像方式安全且便携，非常适合门诊和住院环境，可用于评估多个关节的多个平面，并显示疾病活动和结构损伤随时间的变化。MSKUS 在风湿病学家中越来越受欢迎，因为越来越多的证据支持医生进行的超声评估比传统的临床、实验室和放射学测量具有更高的附加值，从而使诊断和管理决策更有信心。尽管需要更多的纵向数据，并且可能会出现更多的应用，但 MSKUS 很可能具有促进炎症性关节炎管理最佳实践的必要属性。
