Musculoskeletal ultrasonography in rheumatology

Aims: To evaluate the evolution of musculoskeletal ultrasonography and its role in rheumatological practice by comparing recent casuistics of the ultrasonography exams performed at the Rheumatology Department of University Hospital La Paz – Madrid with the exams performed before 2003. Material and methods: Revision of the ultrasonographies made between January 2007 and June 2008 and comparison with the exams performed between 1998 and 2003. Results: In the recent casuistics, that included 1,000 exams, anatomic ultrasonography represents 45.9% in contrast to 100% of the ultrasonographies preformed before 2003. The indication for the remaining 54.1% were: diagnosis of arthritis 16.3%, evaluation of inflammatory activity 6.8%, evaluation of enthesis 6.3%, study of temporal arteries 12.5% (9.7% for suspected temporal arteritis and 2.8% for disease monitoring); differential diagnosis of gout or chondrocalcinosis 2.2%, diagnosis of sacroiliitis 1.2%, diagnosis of carpal tunnel syndrome 1.5% and sonographic-guided procedures 7,3%. Conclusions: At the present time, the anatomic ultrasonography represents 45.9% of all ultrasonographies in contrast to what happened before 2003. Technological advances and the progress in science promote the evolution of ultrasonography from an anatomical imaging tool to a more clinical, diagnostic, monitoring and therapeutic profile