Patients with joint-related symptoms may be able to get a more definitive diagnosis through greater use of musculoskeletal ultrasound, a new study has found.
Researchers at the Karolinska Institute in Stockholm, Sweden, wanted to find out whether it would be helpful to include musculoskeletal ultrasound as part of the standard rheumatologic investigation.
They studied 103 patients without prior rheumatologic diagnosis, who were referred to their clinic for evaluation of inflammatory arthritis. Patients were assessed clinically using the usual methods, including joint examination, laboratory testing including acute-phase reactants, rheumatoid factor (RF) and anti citrulinated protein antibody (ACPA), and radiographs of hands and feet if clinically indicated.
Next, the rheumatologist made a diagnostic assessment giving the probability of any inflammatory arthritis, and rheumatoid arthritis in particular.
Subsequently, an ultrasound examination was performed to look in detail at the wrist, metacarpophalangeal (MCP), proximal interphalangeal (PIP) joints 2 to 5 in both hands, metatarsophalangeal (MTP) joints 2 to 5 in both feet and any symptomatic joints.
The same rheumatologist then assessed the diagnostic probabilities again.
Results showed that the rheumatologists´ certainty for the presence or absence of inflammatory arthritis and rheumatoid arthritis was significantly higher following the ultrasound examination. It was also found that musculoskeletal ultrasound scan findings agreed with the final diagnosis in 95% of patients.
The researchers concluded that musculoskeletal ultrasound, when added to routine rheumatologic investigation, greatly increases diagnostic certainty in patients referred for the evaluation of inflammatory arthritis.
The findings of the study have been published in the journal Arthritis Research & Therapy.