Will sonography change the therapeutic algorithm in rheumatoid arthritis?

Abstract

Rheumatoid arthritis (RA) is an invalidating disease, but its evolution can be stopped before permanent destructive injuries occur, if it is recognized in time and aggressively treated in its early stages, using the new drugs available. Among the new imaging modalities, ultrasonography (US) allows detection, assessment and monitoring of inflammatory and destructive joint injuries in patients with early RA, being comparable with magnetic resonance imaging and more sensitive than conventional radiology or clinical examination. US assesses synovitis, joint effusion, bone erosions and changes in ligaments and tendons. US contributes to  differentiating transitory versus persistent arthritis, assists in establishing follow-up parameters and allows an optimised therapeutic decision.