Conventional radiograph has been and still is the gold standard measure to evaluate the joint damage of rheumatoid arthritis (RA), visualizing the features characteristic to RA such as bone erosion and joint space narrowing. The Larsen grade is utilized in the evaluation of large joints, whereas the Sharp score and its modified versions are commonly used in clinical trials to quantify the joint damage progression. Ultrasound, on the other hand, can visualize both synovial inflammation and the subsequent structural damage, which shifted the paradigm of imaging in RA. Our data indicate that the evaluation of synovial inflammation with ultrasound improves the accuracy of diagnosis and disease activity assessment of RA.
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