Journal Mobile

HI Keen, AK Brown, RJ Wakefield, PG Conaghan
Journal Issue: 
Volume 35: Issue 4: 2005




Rheumatologists  are  increasingly  utilising  MUS  in  both  the  research setting and in clinical practice.  Factors such as improvements in image quality and decreasing  cost  of  machines  have  made  MUS  more  accessible  in  the  routine clinical care setting.

Musculoskeletal ultrasonography is an attractive tool, as it is portable and can be used in the outpatient clinic, allowing multiple joints to be imaged in a single visit. In contrast to conventional radiography, it allows multiplanar imaging of soft tissue structures, such as tendons and synovium, as well as providing information about articular integrity. As MUS does not require ionising radiation or contrast agents, it  can  be  used  repeatedly  to  monitor  temporal  changes.   However, as  with  all imaging techniques, there are technical limitations which, to some extent, may vary between machines; access to some joints may be limited, and the quality of image obtained  may  depend  on  the  size  of  joint  and  the  frequency  of  the  MUS transducer employed.

Whilst  MUS  shows  much  promise  in  aiding  and  optimising  the  practice  of rheumatology, there is still a relative paucity of evidence to fully demonstrate the utility of MUS.  In addition, a number of practical issues need addressing.  These include educational aspects relating to the competence of physicians performing MUS, confirming MUS definitions of pathology, establishing validity and reliability,
and further understanding the utility of this modality in managing rheumatological diseases. Work is underway to address many of these issues.