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Supplementary Table 1. Selected indications and diagnostic value of ultrasonography in the management of rheumatic diseases.
Disease / Clinical focus / Sensitivity / Specificity / Study
Musculoskeletal
Carpal tunnel syndrome / Cross-sectional areaof median nerve vs clinical and electrodiagnostic testing / 77.6% / 86.8% / 1
Crystal-arthropathy / 2
Gout / Crystal deposition vs synovial fluid microscopy / 86.7-96.0% / 73.0-96.4% / 3,4
Uric acid nephrolithiasis / 5
Chondrocalcinosis / Intra-cartilaginous hyperechoic spots vs synovial fluid microscopy / 86.7% / 96.4% / 6,7
Osteoarthritis / Knee: Effusion or synovitis vs clinics or MR / 71.6-75.0% / 43.2-45.0% / 8-10
Interphalagneal finger joints: Erosive disease vs MR / 62-72% / 87-100% / 11,12
Polymyalgia rheumatica / Shoulder: ultrasonography vs diagnosis of PMR / 92.9% / 99.1% / 13
Hip, trochanteric bursitis: ultrasonography vs MR / 100% / 14
Polymyositis / Contrast-enhanced ultrasonographyvs histology / 73% / 91% / 15,16,
17
Psoriatic arthritis / Synovitis of hands and feet: ultrasonography vs MR / 71% / 84-94% / 18
Rheumatoid arthritis / Peripheral joints: PDUS vs MR / 88.8% / 97.9% / 19,20
Ultrasonography synovitis in undifferentiated arthritis vs diagnosis (1987 ACR criteria) after 1 year / 63% / 98% / 21
Spondyloarthritis / Peripheral arthritis / 22
Sacroiliitis unenhanced ultrasonography vs. MR / 17% / 96% / 23
Contrast-enhanced ultrasonography vs MR / 94% / 86% / 23
Enthesitis: MASES ≥20 for spondyloarthritis (ASAS criteria) / 55.8% / 89.5% / 24
Others
Giant cell arteritis / Ultrasonography halo, stenosis or occlusion vs ACR criteria / 78% / 88% / 25
Unilateral ultrasonography halo vs ACR criteria / 68% / 91% / 26
Ultrasonographyhalo, stenosis or occlusion vs clinical diagnosis / 87% / 96% / 27
Raynaud syndrome / Differentiation of primary/secondary syndrome / 28,29
Sjögren syndrome / Involvement of salivary glands vs diagnosis / 48-90% / 93-99% / 30,31
Takayasu arteritis / Ultrasonography correlates with angiography and MR angiography (agreement in >95%) / 32
Thrombosis (in Behçet or antiphospholipid syndrome) / Proximal deep vein thrombosis vs angiography (in symptomatic patients) / 96% / 98% / 33
Abbreviations: ACR, American College of Rheumatology; ASAS, Assessment of Spondyloarthritis Society; CDUS, color Doppler ultrasonography; MASES, Maastricht Ankylosing Spondylitis Enthesitis Score; MR, magnetic resonance.
  1. Fowler, J.R., Gaughanm, J.P. & Ilyas, A.M. The sensitivity and specificity of ultrasound for the diagnosis of carpal tunnel syndrome: A meta-analysis. Clin.Orthop.Relat.Res. (2010) [Epub ahead of print].
  2. Dalbeth, N. and McQueen, F.M. Use of imaging to evaluate gout and other crystal deposition disorders. Curr.Opin.Rheumatol.21, 124-131 (2009).
  3. Rettenbacher, T., et al. Diagnostic imaging of gout: comparison of high-resolution US versus conventional X-ray. Eur.Radiol.18, 621-630 (2008).
  4. Filippou, G., et al. A “new” technique for the diagnosis of chondrocalcinosis of the knee: sensitivity and specifi city of high-frequency ultrasonography. Ann.Rheum.Dis.66, 1126 – 1128 (2007).
  5. Liebman, S.E., Taylor, J.G. & Bushinsky, D.A. Uric acid nephrolithiasis. Curr.Rheumatol.Rep.9, 251-257 (2007).
  6. Filippucci, E., Riveros, M.G., Georgescu, D., Salaffi, F. & Grassi W. Hyaline cartilage involvement in patients with gout and calcium pyrophosphate deposition disease. An ultrasound study. Osteoarthr.Cartilage.17, 178-181 (2009).
  7. Filippucci, E., et al. Ultrasound imaging for the rheumatologist. XXV. Sonographic assessment of the knee in patients with gout and calcium pyrophosphate deposition disease. Clin.Exp.Rheumatol.28, 2-5 (2010).
  8. Conaghan, P., et al. EULAR report on the use of ultrasonography in painful knee osteoarthritis. Part 2: exploring decision rules for clinical utility. Ann.Rheum.Dis.64, 1710-1714 (2005).
  9. D'Agostino, M.A., et al. EULAR report on the use of ultrasonography in painful knee osteoarthritis. Part 1: prevalence of inflammation in osteoarthritis. Ann.Rheum.Dis.64, 1703-1709 (2005).
  10. Sellam, J., and Berenbaum, F. The role of synovitis in pathophysiology and clinical symptoms of osteoarthritis. Nat.Rev.Rheumatol.6, 625-635 (2010).
  11. Wittoek, R., et al. Reliability and construct validity of ultrasonography of soft tissue and destructive changes in erosive osteoarthritis of the interphalangeal finger joints: a comparison with MRI. Ann.Rheum.Dis.70, 278-283 (2011).
  12. Keen, H.I., Wakefield, R.J. & Conaghan, P.G. A systematic review of ultrasonography in osteoarthritis. Ann.Rheum.Dis.68, 611-619 (2009).
  13. Cantini, F., et al. Shoulder ultrasonography in the diagnosis of polymyalgia rheumatica: a case-control study. J.Rheumatol.28, 1049-1055 (2001).
  14. Cantini, F., et al. Inflammatory changes of hip synovial structures in polymyalgia rheumatica. Clin.Exp.Rheumatol.23, 462-468 (2005).
  15. Weber, M.A., et al. Pathologic skeletal muscle perfusion in patients with myositis: detection with quantitative contrast-enhanced US - initial results. Radiology 238, 640–649 (2006).
  16. Weber, M.A., et al. Contrast-enhanced ultrasound in dermatomyositis- and polymyositis. J.Neurol.253, 1625-1632 (2006).
  17. Adler, R.S. and Garofalo, G. Ultrasound in the evaluation of the inflammatory myopathies. Curr.Rheumatol.Rep.11, 302-308 (2009).
  18. Weiner, S.M., et al. Ultrasonography in the assessment of peripheral joint involvement in psoriatic arthritis : a comparison with radiography, MRI and scintigraphy. Clin.Rheumatol.27, 983-989 (2008).
  19. Szkudlarek, M., et al.Power Doppler ultrasonography for assessment of synovitis in the metacarpophalangeal joints of patients with rheumatoid arthritis: a comparison with dynamic magnetic resonance imaging.Arthritis Rheum.44, 2018-2023 (2001).
  20. Brown, A.K. Using ultrasonography to facilitate best practice in diagnosis and management of RA. Nat.Rev.Rheumatol.5, 698-706 (2009).
  21. Rahmani, M., et al. Detection of bone erosion in early rheumatoid arthritis: ultrasonography and conventional radiography versus non-contrast magnetic resonance imaging. Clin.Rheumatol.29, 883-891 (2010).
  22. van Tubergen, A.M. and Landewé, R.B. Tools for monitoring spondyloarthritis in clinical practice. Nat.Rev.Rheumatol.5, 608-615 (2009).
  23. Klauser, A., et al. Inflammatory low back pain: high negative predictive value of contrast-enhanced color Doppler ultrasound in the detection of inflamed sacroiliac joints. Arthr. Rheum.53, 440-444 (2005).
  24. de Miguel, E., Muñoz-Fernández, S., Castillo, C., Cobo-Ibáñez, T. & Martín-Mola, E. Diagnostic accuracy of enthesis ultrasound in the diagnosis of early spondyloarthritis. Ann.Rheum.Dis.70, 434-439 (2011).
  25. Ball, E.L., Walsh, S.R., Tang, T.Y., Gohil, R. & Clarke, J.M. Role of ultrasonography in the diagnosis of temporal arteritis. Br.J.Surg.97, 1765-1771 (2010).
  26. Arida, A., Kyprianou, M., Kanakis, M. & Sfikakis, P.P. The diagnostic value of ultrasonography-derived edema of the temporal artery wall in giant cell arteritis: a second meta-analysis. BMC Musculoskelet.Disord.11, 44 (2010).
  27. Karassa, F.B., Matsagas, M.I., Schmidt, W.A. & Ioannidis, J.P. Meta-analysis: test performance of ultrasonography for giant-cell arteritis. Ann.Intern.Med.142, 359-369 (2005).
  28. Schmidt, W.A., Krause, A., Schicke, B. & Wernicke, D. Color Doppler ultrasonography of hand and finger arteries to differentiate primary from secondary forms of Raynaud's phenomenon. J.Rheumatol.35, 1591-1598 (2008).
  29. Schmidt, W.A., Wernicke, D., Kiefer, E. & Gromnica-Ihle, E. Colour duplex sonography of finger arteries in vasculitis and in systemic sclerosis. Ann.Rheum.Dis. 65, 265-267 (2006).
  30. Wernicke, D., Hess, H., Gromnica-Ihle, E., Krause, A. & Schmidt, W.A. Ultrasonography of salivary glands - a highly specific imaging procedure for diagnosis of Sjögren's syndrome. J.Rheumatol.35, 285-293 (2008).
  31. Milic, V.D., et al. Major salivary gland sonography in Sjögren's syndrome: diagnostic value of a novel ultrasonography score (0-12) for parenchymal inhomogeneity. Scand.J. Rheumatol.39, 160-166 (2010).
  32. Andrews, J. and Mason, J.C. Takayasu's arteritis - recent advances in imaging offer promise. Rheumatology (Oxford)46, 6-15 (2007).
  33. Gaitini, D. Current approaches and controversial issues in the diagnosis of deep vein thrombosis via duplex Doppler ultrasound. J.Clin.Ultrasound34, 289-297 (2006).