Validation and incorporation of digital entheses into a preliminary GLobal OMERACT Ultrasound DActylitis Score (GLOUDAS) in psoriatic arthritis.

Objectives: The main objective was to generate a GLobal OMERACT Ultrasound DActylitis Score (GLOUDAS) in psoriatic arthritis and to test its reliability. To this end, we assessed the validity, feasibility and applicability of ultrasound assessment of finger entheses to incorporate them into the scoring system.

Methods: The study consisted of a stepwise process.

An ultrasound study of the long posterior sacroiliac ligament in healthy volunteers and in patients with noninflammatory sacroiliac joint pain.

Aim: To describe the sonoanatomy of the long posterior sacroiliac ligament (LPSL) in healthy volunteers and to assess by ultrasound the LPSL in patients with noninflammatory sacroiliac joint pain (SIP).

Material And Methods: We assessed 64 LPSLs of 32 healthy controls and 40 LPSLs of 40 patients with unilateral noninflammatory SIP and a positive Fortin finger test. LPSLs in both groups were assessed for the presence of alterations in their structure, continuity and echogenicity and their thickness was measured in three predefined points.

Persistence with Denosumab in Women at High Risk of Fracture in Bulgaria.

Introduction: Post-menopausal women with osteoporosis > 70 years of age at high risk of fracture urgently require treatment for fracture prevention. Moreover, persistence with osteoporosis therapy is critical for real-world effectiveness. We estimated persistence with denosumab in older women at high fracture risk in clinical practice in Bulgaria.

The sonoanatomy of lumbar erector spinae and its iliac attachment - the potential substrate of the iliac crest pain syndrome, an ultrasound study in healthy subjects.

Background: Iliac crest pain syndrome is a regional pain syndrome that has been identified in many patients with low back pain. Based on anatomical studies, it was suggested that the potential substrate of this syndrome might be the enthesis of the erector spinae muscle at the posterior medial iliac crest. As there have been no imaging studies of this important enthesis, our aim was to assess its characteristics by ultrasound.

Diagnostic value of musculoskeletal ultrasound in patients with low back pain - a review of the literature.

Patients with low back pain (LBP) frequently undergo various imaging studies in the pursuit of a more precise diagnosis. Ultrasound (US) has the advantage of being a widely available, multiplanar, fast and radiation-free diagnostic tool. Moreover, compared to most of the other imaging modalities, it is particularly efficient in the visualization and assessment of soft tissues.

The 2017 EULAR standardised procedures for ultrasound imaging in rheumatology.

Background: In 2001, the European League Against Rheumatism developed and disseminated the first guidelines for musculoskeletal (MS) ultrasound (US) in rheumatology. Fifteen years later, the dramatic expansion of new data on MSUS in the literature coupled with technological developments in US imaging has necessitated an update of these guidelines.

Objectives: To update the existing MSUS guidelines in rheumatology as well as to extend their scope to other anatomic structures relevant for rheumatology.

Denosumab improves bone mineral density and microarchitecture and reduces bone pain in women with osteoporosis with and without glucocorticoid treatment.

Osteoporosis is a key health problem in postmenopausal women with high social and economic impact. Decreased bone mineral density (BMD) and deterioration of bone microarchitecture may occur also as a result of long-term glucocorticoid treatment (GCT) of autoimmune or inflammatory conditions. Denosumab specifically inhibits the binding of the receptor activator of nuclear factor-κB to its ligand, thus preventing osteoclast activation and bone resorption.

The place of musculoskeletal ultrasonography in gout diagnosis.

Gout represents a common inflammatory arthritis conditions in which the monosodium urate (MSU) crystals are deposited in joints and other tissues producing attacks of acute arthritis/ chronic arthropathy with important destructive lesions in articular or juxta-articular spaces. High resolution ultrasonography (US) is able to detect these deposits and their consequences: hyaline cartilage pathology, joint effusions, synovitis, bone erosions, tendons, bursitis, and other soft tissues involvement. Moreover, there are characteristic findings of this aggregates that can be detected by US, helping the clinician for positive and differential diagnosis.

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.

Ultrasonography of the hip.

A complete physical examination of the hip is often difficult due to its size and deep position. During the last two decades, ultrasonography (US) of the hip has been widely accepted as a useful diagnostic tool in patients with hip pain and /or limited range of motion. It is commonly used in both adults and children.

Ultrasound assessment of the elbow.

Ultrasonography of the elbow is a very helpful and reliable diagnostic procedure for a broad spectrum of rheumatic and orthopedic conditions, representing a possible substitute to magnetic resonance imaging for evaluation of soft tissues of the elbow. Musculoskeletal ultrasound (US) shows many advantages over other imaging modalities, probably the most important being its capability to perform a dynamic assessment of musculoskeletal elements with patient's partnership and observation during examination. In addition, ultrasonography is cost effective, easy available, and has excellent and multiplanar capability to visualize superficial soft tissue structures.

Ultrasound of the shoulder.

Ultrasonography (US) is a helpful imaging tool in the evaluation of the musculoskeletal system. It has some advantages over the other imaging techniques, such as plain radiography, computed tomography and magnetic resonance imaging, represented by the non-invasiveness and multiplanar imaging capability, repeatability, lack of radiation burden, good patient acceptance, and relatively limited costs. US offers an excellent resolution and a possibility for real-time dynamic examination of the joints and surrounding soft tissues, as well as enables monitoring of therapeutic response.

Ultrasound of the hand and wrist in rheumatology.

Musculoskeletal Ultrasonography (US) is nowadays widely used for clinical grounds and for research purposes in rheumatology. US of the hand and wrist has recently developed due to the technological improvement and use of new, high resolution transducers. US is currently improving clinical examination of the rheumatic hand and wrist and it is commonly used as daily practice by many rheumatologists.

Ultrasound of the ankle and foot in rheumatology.

In the last years musculoskeletal ultrasound (US) has become a very useful imaging tool for the evaluation of rheumatic patients and a natural extension of the clinical examination of the ankle and foot. Musculoskeletal US allows the evaluation of the symptomatic and asymptomatic ankle and foot with a detailed analysis of a wide range of elementary lesions at the level of different anatomical structures and their distribution in early or long standing disease. In inflammatory pathology, it helps in the assessment of the disease activity and severity at the joint, tendon or entheseal level and in the detection of subclinical pathological features in early disease or residual activity after therapy.

The role of Doppler ultrasound in rheumatic diseases.

The use of Doppler techniques, including power, colour and spectral Doppler, has greatly increased in rheumatology in recent years. This is due to the ability of Doppler US (DUS) to detect pathological vascularization within joints and periarticular soft tissues, thereby demonstrating the presence of active inflammation, which has been reported to be correlated with the local neo-angiogenesis. In synovitis, DUS showed a high correlation with histological and MRI findings, thus it is considered a valid tool to detect pathological synovial vascularization.