Integrating point-of-care ultrasound into rheumatology practice.

A scenario‑based probability approach integrating point‑of‑care rheumatology ultrasound (POCRUS) into rheumatology practice has recently been proposed as a teaching methodology to encourage greater awareness of US among practicing clinicians, especially with respect to the management of overlapping clinical conditions. This article reviews the rheumatological areas where application of POCRUS substantially enhances clinical reasoning to confirm or exclude target conditions. It highlights the definitions of US‑detected pathologies in rheumatoid arthritis, spondylarthritis, gout and crystal arthritis, osteoarthritis, and polymyalgia rheumatica, and discusses the added value of POCRUS in diagnosing these conditions.

Validation of the Southend giant cell arteritis probability score in a Scottish single-centre fast-track pathway.

Objective: The aim was to provide external validation of the Southend GCA probability score (GCAPS) in patients attending a GCA fast-track pathway (GCA FTP) in NHS Lanarkshire.

Methods: Consecutive GCA FTP patients between November 2018 and December 2020 underwent GCAPS assessment as part of routine care. GCA diagnoses were supported by US of the cranial and axillary arteries (USS), with or without temporal artery biopsy (TAB), and confirmed at 6 months.

Scottish rheumatology sonography course: five-year experience of delivering a mentorship-model rheumatology ultrasound training programme accredited by the consortium for the accreditation of sonographic education.

Background And Aims: Ultrasound training for rheumatology practice in the UK is variable. Currently, there is no agreed minimum standard for training in ultrasound applied to rheumatology patient management. We present our experiences of implementing a competency driven ultrasound training, focused on hands and feet.

Recommendations for rheumatology ultrasound training and practice in the UK.

Objective: The aim of this paper is to present a UK-based consensus of principles and recommendations to guide rheumatology US training and practice.

Method: A Delphi process was conducted involving 19 US experts representing each of the 14 regions of the UK. A working group of experienced British Society for Rheumatology Ultrasound Special Interest Group (BSRUSSIG) members made seven proposals that were presented to the whole group for further discussion.

Implementation and role of modern musculoskeletal imaging in rheumatological practice in member countries of EULAR.

Objectives: To document the current training, implementation and role of modern musculoskeletal imaging techniques: ultrasound, magnetic resonance imaging, computed tomography and positron emission tomography, among rheumatologists in the member countries of the EULAR.

Methods: English-language questionnaires for each imaging modality developed by a EULAR task force were sent out to national and international scientific societies as well as imaging experts in the given modalities involved in research and/or training. The surveys were distributed via an online survey tool (SurveyMonkey).

Ultrasound image of malignant bone tumors in children. An analysis of nine patients diagnosed in 2011-2016.

Introduction: The diagnostic process of bone tumors, including malignant ones, is based on conventional radiological methods, such as radiography and computed tomography, and with precise assessment of local advancement in magnetic resonance imaging. Ultrasonography is not included in the diagnostic algorithms as a tool suitable to detect this type of pathology. More and more frequent usage of musculoskeletal ultrasound in children as the first imaging method or, in some cases, as the only diagnostic method, makes it necessary to be familiar with sonographic presentation of bone tumors to suggest this diagnosis early enough and, after its verification, start treatment without a significant delay.

Level of agreement between three-dimensional volumetric ultrasound and real-time conventional ultrasound in the assessment of synovitis, tenosynovitis and erosions in rheumatoid arthritis patients.

The aim of the study was to assess agreement between three-dimensional volumetric ultrasound (3D US) performed by inexperienced staff and real-time conventional ultrasound (2D US) performed by experienced rheumatologists in detecting and scoring rheumatoid arthritis (RA) lesions. Thirty-one RA patients underwent examination of seven joints by 2D and 3D US for synovitis and tenosynovitis in B and PD modes and erosions in B mode. A global score for synovitis and global counts for synovitis, tenosynovitis and erosions were also calculated for every patient.

Inter & intra-observer reliability of grading ultrasound videoclips with hand pathology in rheumatoid arthritis by using non- sophisticated internet tools (LUMINA study).

Aim: To evaluate the inter- and intraobserver agreement of a group of European rheumatologist ultrasonographers in grading musculoskeletal ultrasound videoclips posted on the Internet by using a non-sophisticated electronic environment.

Methods: Forty short movie clips (less than 30 secs) were made available over the Internet to all participants. Normal and pathological RA hand joints and tendons were included in the movie clips.

[Magnetic resonance imaging of the hand in rheumatoid arthritis].

The aim of the study was to show the magnetic resonance (MR) images of changes in hands of patients with rheumatoid arthritis (RA). The SE sequence T1-weighted (TR600, TE15) and fat-suppressed (A-250, TR1155, TE22) were obtained with 3 mm coronal scans and matrix 256 x 512, both before and after contrast medium administration. Knee coil was used.

[Ultrasonography of the hand in rheumatoid arthritis].

Authors present the ability of ultrasonography and Color and power Doppler sonography in evaluation of the hand structures in patients with rheumatoid arthritis. Imaging of bony contours allows to identify bone erosions. Thickness, oedema and presence of increased blood flow (hyperaemia) in the synovium in joints and tendon sheaths are characteristic features of an active inflammation.