Rheumatology Department, CHU Montpellier, Montpellier University, Montpellier, France.
Sorbonne Université, Paris, France; Pitié Salpêtrière hospital, AP-HP, Rheumatology department, Paris, France.
Joint Bone Spine. 2021 Jul;88(4):105187. doi: 10.1016/j.jbspin.2021.105187. Epub 2021 Apr 20.
To develop recommendations for the appropriate use of ultrasound in the management of rheumatoid arthritis (RA) in routine practice based on data from the literature and of experts opinion.
Based on a systematic literature review, a scientific committee decided on themes and relevant questions to draw up an initial draft of recommendations. These recommendations were submitted to a group of experts in ultrasound in rheumatic and musculoskeletal diseases using a Delphi method, which produced preliminary recommendations. These were submitted to an expanded group of ultrasound experts for relevance, comprehensibility and comprehensiveness. The level of agreement of the experts were recorded during a face-to-face meeting.
Following two rounds of the Delphi, a consensus was reached on three overarching principles, including definitions of joints, tendons and articular sites to be examined, and 10 recommendations. These recommendations underline the benefit of ultrasound for the diagnosis of RA in cases of inflammatory arthralgia or undifferentiated arthritis as well as in assessing the extent of initial structural and inflammatory damage. They also define the role of ultrasound during follow-up or when considering treatment reduction once clinical remission has been achieved. Lastly, they illustrate the utility of ultrasound in facilitating technical procedures.
These 10 consensus-based recommendations should harmonize and optimize clinical practice and thus improve the management of RA patients.
根据文献数据和专家意见，为常规实践中类风湿关节炎（RA）的超声管理制定合理使用超声的建议。
基于系统文献回顾，一个科学委员会就主题和相关问题进行了讨论，以制定建议的初始草案。这些建议通过德尔菲法提交给一组风湿性和肌肉骨骼疾病的超声专家，从而提出了初步建议。这些建议提交给一个扩大的超声专家小组，以评估其相关性、可理解性和全面性。在面对面会议期间记录了专家的一致性意见。
经过两轮德尔菲法，就三个总体原则达成了共识，包括要检查的关节、肌腱和关节部位的定义，以及 10 条建议。这些建议强调了超声在炎症性关节炎或未分化关节炎以及评估初始结构和炎症损伤程度中的诊断价值。它们还定义了在临床缓解后随访或考虑减少治疗时超声的作用。最后，它们说明了超声在促进技术程序方面的实用性。
这 10 条基于共识的建议应该协调和优化临床实践，从而改善 RA 患者的管理。
