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Introduction: Musculoskeletal Ultrasound Indications and Fundamentals

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Musculoskeletal Ultrasound in Rheumatology Review
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Abstract

Combining history and clinical examination with clinician-performed ultrasound enables the rheumatologist to clearly define rheumatic disease entities.

This introduction provides an overview of indications for ultrasound in rheumatology ranging from musculoskeletal pathologies to connective tissue diseases and vasculitis.

The chapter also describes the technical fundamentals of ultrasound including: basic ultrasound physics, “knobology” and how to operate ultrasound equipment, probe orientation/maneuvers, and ultrasound ergonomics.

Distinct anatomic structures like bone, fluid, tendons, and muscles appear differently on an ultrasound image.

Not all signals on an ultrasound image may represent true anatomical structures. This chapter reviews common ultrasound artifacts that the sonographer needs to know, which may mimic pathology but may also be helpful for identifying anatomic structures.

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References

  1. McAlindon T, Kissin E, Nazarian L, Ranganath V, Prakash S, Taylor M, et al. American College of Rheumatology report on reasonable use of musculoskeletal ultrasonography in rheumatology clinical practice. Arthritis Care Res. 2012;64:1625–40.

    Google Scholar 

  2. Larché MJ, Seymour M, Lim A, Eckersley RJ, Pétavi F, Chiesa F, et al. Quantitative power Doppler ultrasonography is a sensitive measure of metacarpophalangeal joint synovial vascularity in rheumatoid arthritis and declines significantly following a 2-week course of oral low-dose corticosteroids. J Rheumatol. 2012;37:2493–501.

    Google Scholar 

  3. Wakefield RJ, Gibbon WW, Conaghan PG, O’Connor P, McGonagle D, Pease C, et al. The value of sonography in the detection of bone erosions in patients with rheumatoid arthritis: a comparison with conventional radiography. Arthritis Rheum. 2000;43:2762–70.

    Google Scholar 

  4. Iagnocco A. Imaging the joint in osteoarthritis: a place for ultrasound? Best Pract Res Clin Rheumatol. 2010;24:27–38.

    Google Scholar 

  5. Riente L, Carli L, Delle Sedie A. Ultrasound imaging in psoriatic arthritis and ankylosing spondylitis. Clin Exp Rheumatol. 2014;32(1Suppl 80):S26–33.

    Google Scholar 

  6. Terslev L, Naredo E, Iagnocco A, Balint PV, Wakefield RJ, Aegerter P, et al. Defining enthesitis in spondyloarthritis by ultrasound: results of a Delphi process and of a reliability reading exercise. Arthritis Care Res (Hoboken). 2014;66:741–8.

    Google Scholar 

  7. Banal F, Gandjbakhch F, Foltz V, Goldcher A, Etchepare F, Rozenburg S, et al. Sensitivity and specificity of ultrasonography in early diagnosis of metatarsal bone stress fractures: a pilot study of 37 patients. J Rheumatol. 2009;36:1715–9.

    Google Scholar 

  8. Cartwright MS, Walker FO. Neuromuscular ultrasound in common entrapment neuropathies. Muscle Nerve. 2013;48:696–704.

    Google Scholar 

  9. Thiele RG, Schlesinger N. Diagnosis of gout by ultrasound. Rheumatology (Oxford). 2007;46:1116–21.

    Google Scholar 

  10. Filippou G, Filippucci E, Tardella M, Pertoldi I, Di Carlo M. Adinolfi A. Extent and distribution of CPP deposits in patients affected by calcium pyrophosphate dihydrate deposition disease: an ultrasonographic study. Ann Rheum Dis. 2013;72:1836–9.

    Google Scholar 

  11. Macchioni P, Boiardi L, Catanoso M, Pazola G, Salvarani C. Performance of the new 2012 EULAR/ACR classification criteria for polymyalgia rheumatica: comparison with the previous criteria in a single-centre study. Ann Rheum Dis. 2014;73:1190–3.

    Google Scholar 

  12. Schmidt WA, Krause A, Schicke B, Wernicke D. Color Doppler ultrasonography of hand and finger arteries to differentiate primary from secondary forms of Raynaud’s phenomenon. J Rheumatol. 2008;35(8):1591–8.

    Google Scholar 

  13. Wernicke D, Hess H, Gromnica-Ihle E, Krause A, Schmidt WA. Ultrasonography of salivary glands – a highly specific imaging procedure for diagnosis of Sjögren’s syndrome. J Rheumatol. 2008;35:285–93.

    Google Scholar 

  14. Schmidt WA, Backhaus M. What the practising rheumatologist needs to know about the technical fundamentals of ultrasonography. Best Pract Res Clin Rheumatol. 2008;22:981–99.

    Google Scholar 

  15. Bruyn GA, Schmidt WA. Introductory guide to musculoskeletal ultrasound for the rheumatologist. Houten, NL: Bohn Stafleu van Loghum/Springer; 2011. ISBN 978-90-313-9206-3.

    Google Scholar 

  16. Taljanovic MS, Melville DM, Scalcione LR, Gimber LH, Lorenz EJ, Witte RS. Artifacts in musculoskeletal ultrasonography. Semin Musculoskeletal Radiol. 2014;18:3–11.

    Google Scholar 

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Correspondence to Wolfgang A. Schmidt MD .

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© 2016 Springer International Publishing Switzerland

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Schmidt, W.A. (2016). Introduction: Musculoskeletal Ultrasound Indications and Fundamentals. In: Kohler, M. (eds) Musculoskeletal Ultrasound in Rheumatology Review. Springer, Cham. https://doi.org/10.1007/978-3-319-32367-1_1

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  • DOI: https://doi.org/10.1007/978-3-319-32367-1_1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-32365-7

  • Online ISBN: 978-3-319-32367-1

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