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Taipei City Hospital


Applications of musculoskeletal ultrasonography for rheumatoid arthritis

       Musculoskeletal ultrasonography is a growing imaging technique in rheumatology in recent years which is used to diagnose musculoskeletal system diseases. Unlike traditional X-ray imaging, musculoskeletal ultrasound can provide images of the surfaces of joint synovia, tendons, ligaments, muscles and bones, while assessing the subject’s movement in motion. Employing the Doppler effect, a power Doppler ultrasound can detect microvascular blood flows to further assess the degree of joint inflammation.
       “The applications of musculoskeletal ultrasonography in rheumatoid arthritis,” said Dr. Ming-Hsueh Tsai, a rheumatologist at Taipei City Hospital Heping Fuyou Branch, “mainly include the following:

  1. Early diagnosis: For detecting early rheumatoid arthritis, ultrasound is more sensitive than clinical examinations.  
  2. Disease surveillance: The change in ultrasound images can be used for follow-ups and post-treatment reactions to the status of rheumatoid arthritis.
  3. Prognostic assessment: Detection of bone erosion in the early stage of the disease represents a poor prognosis. Clinicians can actively use disease-modifying antirheumatic drugs in the early stages for rheumatoid arthritis treatment.
  4. Interventional treatment: Joint fluid aspiration and joint injection are both procedures to diagnose and treat rheumatoid arthritis. The traditional approach is to use palpation to find the bones on the body’s surface as positioning targets, though this usually results in the failure of diagnoses and treatments, particularly for smaller joints or joints that are difficult to perform regular palpation on. With the introduction of ultrasonography and real-time motion imaging, the location of lesions can be accurately positioned, increasing the success rate of diagnosis and treatment.”