Background/Purpose: It is well established in the literature that musculoskeletal ultrasound (MSUS) is more sensitive than clinical examination in the detection of synovitis. MSUS can help rheumatologists with the diagnosis and follow-up of uncertain cases. The main objective of this study is to validate the added value of MSUS in the diagnosis and follow-up of patients presenting with arthritis in the rheumatology department of the CHUS.

Methods: We reviewed retrospectively the medical records of patients with an uncertain initial diagnosis of arthritis (Group 1: n=58) and patients with clinically uncertain disease activity on follow-up (Group 2: n=103). We examined the contribution of MSUS in the diagnosis of arthritis and its impact on treatment decision making.

Results: In group 1, 56.9% of patients were confirmed with polyarthritis after MSUS (n=33). 54.5% of them were diagnosed with rheumatoid arthritis (n=18). There were no statistically significant predictors for a positive MSUS. In the follow-up group, 27.2% had a positive MSUS (n=28). 67.9% had their treatment optimised (n=19). 44.4% of patients with positive ultrasound but without treatment modification had articular infiltrations following the MSUS (n=4). Within patients with negative ultrasound (n=75), 10% had a decrease in their medication (n=8) while 71% had no change in their treatment (n=53). The result of the ultrasound had a statistically significant impact on the treatment decision making (p <0.0001).

Conclusion: Our results support the added value of MSUS in the diagnosis and management of polyarthritis, mainly in patients whith a doubtful clinical picture. Similar results can be found in the current literature. We did not succeed to identify predictive factors of a positive ultrasound.

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/clinical-impact-of-articular-ultrasound-in-diagnosis-and-follow-up-of-patients-with-polyarthritis/