The impact of ultrasonography on diagnosis and management of patients with musculoskeletal conditions

Karim, Zunaid; Wakefield, Richard J.; Conaghan, Philip G.; Lawson, CA; Goh, En Lin; Quinn, Mark; Astin, Paul; O’Connor, Philip; Gibbon, Wayne; Emery, Paul

doi:10.1002/1529-0131(200112)44:12<2932::aid-art481>3.0.co;2-3

Cited by 141 publications

(78 citation statements)

References 18 publications

(13 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our results suggest that the measurement of synovial fluid in the knee in the suprapatellar scan with the knee flexed to 30°allows the most optimal detection of even minimal amounts of abnormal joint effusion in agreement with recent findings obtained in salineinjected cadavers (18). Performing a dynamic ultrasound examination may also influence the physician to change the anatomic diagnosis of involved structures in certain musculoskeletal conditions and, consequently, the planning of joint injections and that of overall treatment (19,20). Such modifications were associated with a trend towards improved short-term symptomatic treatment effect by rheumatologists (20).…”

Section: Discussionsupporting

confidence: 88%

“…Performing a dynamic ultrasound examination may also influence the physician to change the anatomic diagnosis of involved structures in certain musculoskeletal conditions and, consequently, the planning of joint injections and that of overall treatment (19,20). Such modifications were associated with a trend towards improved short-term symptomatic treatment effect by rheumatologists (20). This can be easily performed with the use of a standard goniometer and does not significantly lengthen the ultrasound examination.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Ultrasound evaluation of fluid in knee recesses at varying degrees of flexion

Mandl¹,

Brossard²,

Aegerter³

et al. 2012

Arthritis Care & Research

Self Cite

View full text Add to dashboard Cite

Objective. Various methods are utilized in daily practice to obtain optimal information on effusion in the knee. Our aim is to investigate which scanning position provides the best information about synovial fluid in the knee by using ultrasound and to evaluate the magnitude of difference for measuring synovial fluid in 3 major recesses (suprapatellar, medial parapatellar, and lateral parapatellar) of the knee according to various degrees of flexion. Methods. Sonographers in 14 European

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Ultrasound evaluation of fluid in knee recesses at varying degrees of flexion

Mandl¹,

Brossard²,

Aegerter³

et al. 2012

Arthritis Care & Research

Self Cite

View full text Add to dashboard Cite

show abstract

“…This imaging technique is a valuable complementary clinical tool enabling clinicians to improve the accuracy of their diagnostic skills and management decisions essential for maintaining the highest standards of patient care (8). It is also of considerable utility to the researcher, allowing improved understanding of the pathophysiology of rheumatic diseases and as an objective outcome measure for clinical research studies (9 -11).…”

Section: Introductionmentioning

confidence: 99%

Recommendations for musculoskeletal ultrasonography by rheumatologists: Setting global standards for best practice by expert consensus

Brown

O’Connor

Roberts

et al. 2005

Arthritis & Rheumatism

View full text Add to dashboard Cite

Objective. To establish an expert consensus of best practice for rheumatologists performing musculoskeletal ultrasonography (MUS).Methods. A panel of worldwide experts in MUS was identified by literature review, membership of teaching faculty, and peer recommendation. They were invited to take part in a 4-stage Delphi process employing 2 iterative rounds to establish a consensus of specific indications, anatomic areas, and knowledge and skills required by rheumatologists performing MUS. Results. Experts in MUS were identified (n ‫؍‬ 57; 37 radiologists, 20 rheumatologists). Successive rounds of this rigorousDelphi exercise enabled group consensus to be achieved in 30 of the proposed 37 categories comprising 8 of 13 indications (inflammatory arthritis, tendon pathology, effusion, bursitis, monitoring disease activity, monitoring disease progression, guided aspiration, and injection), 8 of 10 anatomic areas (hand, wrist, elbow, shoulder, hip, knee, ankle and heel, and forefoot), and 14 categories of knowledge and skills (physics, anatomy, pathology, equipment, clinical application and relevance, indications and limitations, artifact, machine function and operation, patient and probe position, planes and system of examination, image optimization, dynamic assessment, color Doppler, and power Doppler). Conclusion. We have produced the first expert-derived, interdisciplinary consensus of recommendations for rheumatologists performing MUS. This represents a significant advance that will not only direct future rheumatology MUS practice, but will facilitate informed educational development. This is an important step towards the introduction of a specific training curriculum and assessment process to ensure competent rheumatologist ultrasonographers.

show abstract

“…It has also been suggested that US guiding could improve the efficacy of local CS injections in inflammatory rheumatism (27)(28)(29)(30)(31). Nevertheless, despite such results, and considering that appropriate therapy might strongly depend on accurate diagnosis, studies addressing the impact of US on the anatomic diagnosis by physicians and on therapeutic decision are scarce (32).…”

Section: Introductionmentioning

confidence: 99%

Impact of ultrasound imaging on local corticosteroid injections of symptomatic ankle, hind‐, and mid‐foot in chronic inflammatory diseases

D'Agostino¹,

Ayral²,

Baron³

et al. 2005

Arthritis & Rheumatism

View full text Add to dashboard Cite

Objective. To assess the impact of ultrasonography (US) on local corticosteroid (CS) injections of painful ankle, hindfoot, and midfoot in chronic inflammatory diseases.Methods. Consecutive patients with chronic rheumatic diseases admitted to the hospital for local CS injections of painful ankle, hindfoot, or midfoot were enrolled in this study. Clinical and radiographic evaluation was performed by the physician in charge of CS injections, and US examination was performed by an independent examiner blinded to the clinical and radiologic findings. According to a randomized weekly-periods design, the physician planned CS injections either aware (G1 group) or unaware (G2 group) of US results. In the latter case, he was nonetheless informed of US results after he had performed the injections. Impact of this information on the treatment planning was assessed in all cases. Prognostic impact of US was also evaluated by comparing the change in global assessment of efficacy of CS injections, in activity of the disease, and in the Western Ontario and McMaster Universities (WOMAC) subscales after 1 and 3 months, between G1 and G2 groups. Results. The knowledge of US findings led the physician to change his decision of local CS injections in 56 (82%) of 68 patients studied. Among 1,131 assessed sites, by clinical, radiographic, and US evaluation, injection was cancelled in 37 (15%) of 242 proposed sites, whereas it was decided in 74 (8%) additional sites. After 1 month, there was an improvement in G1 as compared with G2 groups. The mean ؎ SD change in WOMAC physical function subscale was 15.6 ؎ 17.5 in G1 versus 8 ؎ 13 in G2 (P ‫؍‬ 0.0305). After 3 months, only the global assessment of efficacy of CS injections was statistically greater in G1 than in G2 group (P ‫؍‬ 0.0170). Conclusion. US frequently led the physician to change his diagnosis of inflammatory lesions in painful foot, and consequently his planning of CS injections. Moreover, US could improve the response to local treatment.

show abstract

The impact of ultrasonography on diagnosis and management of patients with musculoskeletal conditions

Cited by 141 publications

References 18 publications

Ultrasound evaluation of fluid in knee recesses at varying degrees of flexion

Ultrasound evaluation of fluid in knee recesses at varying degrees of flexion

Recommendations for musculoskeletal ultrasonography by rheumatologists: Setting global standards for best practice by expert consensus

Impact of ultrasound imaging on local corticosteroid injections of symptomatic ankle, hind‐, and mid‐foot in chronic inflammatory diseases

Contact Info

Product

Resources

About