Guidance particularly addresses the value of ultrasound in patient-provider shared decision-making in management of care.
"Even in the last 12 years, we've seen substantive advances, and there's been significant improvements in musculoskeletal ultrasound technology," Veena K. Ranganath, MD, a professor of clinical medicine at the University of California, Los Angeles, and director of their Rheumatology Fellowship Musculoskeletal Ultrasound Training Program, told attendees. She noted that more than 30,000 articles on MSUS and arthritis have been published since the 2012 guidance.
"Ultrasound is becoming part of the landscape, and so increasingly, we're trying to promote it as being part of the standard of care, or at least an adjunct to care. I commend the committee for doing all this amazing work." Catherine Bakewell, MD, a rheumatologist at Intermountain Health in Salt Lake City, Utah, reviewed the committee's statements, starting with strong consensus that MSUS can help with diagnosing early psoriatic arthritis.
Moderate consensus also supported reliance on entheseal features — including hypoechogenicity, thickening, Doppler signal, bone erosions, enthesophytes/calcifications, and bursal enlargement — to support a diagnosis. Interpretation of entheseal changes in patients with psoriasis should take into account characteristics such as age, body mass index , and biomechanical stress.
"I will also note that enthesitis is missing from this definition of dactylitis," Bakewell said."It is, however, a feature that is detectable with those higher-frequency transducers, but this is a relatively early area of research and did not make it into this guidance statement." "We've all had this in our practices. You've had the patient in front of you who is very inflamed, and they say, 'Doctor, can't I please use doTERRA oils? Do I really need to go on one of these toxic drugs? I've read the package insert,'" Bakewell said.
Arthropathic Psoriasis Psoriatic Arthropathy Psa Ultrasonography Ultrasound Sonogram Arthritis Joint Inflammation Cardiovascular Imaging Cardiac Imaging CV Imaging Doppler Ultrasonography Ankylosing Spondylitis Rheumatoid Spondylitis Rheumatoid Arthritis Of The Spine Bechterew's Disease Bechterew Syndrome Marie Strumpell Disease Marie Struempell Disease
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