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Ann Rheum Dis. 2017 Dec;76(12):1974-1979. doi: 10.1136/annrheumdis-2017-211585. Epub 2017 Aug 16.

The 2017 EULAR standardised procedures for ultrasound imaging in rheumatology.

Author information

1
Department of Rheumatology, Instituto Poal de Reumatología, Barcelona, Spain.
2
Barcelona University, Barcelona, Spain.
3
Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
4
Department of Internal Medicine - Rheumatology and Clinical Immunology, Park-Klinik Weissensee, Berlin, Germany.
5
Department of Rheumatology and Clinical Immunology, Charité University Medicine, Berlin, Germany.
6
Department of Radiology-III, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy.
7
Department of Rheumatology, Università Politecnica delle Marche, Ancona, Italy.
8
Unit of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Galeazzi, Milano, Italy.
9
Department of Biomedical Sciences for Health, University of Milano, Milano, Italy.
10
Centre for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark.
11
Institute of Rheumatology, University of Belgrade School of Medicine, Belgrade, Serbia.
12
Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
13
Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.
14
Imaging Diagnostic Department, Warsaw Medical University, Warsaw, Poland.
15
3rd Department of Rheumatology, National Institute of Rheumatology and Physiotherapy, Budapest, Hungary.
16
Department of Rheumatology, MC Groep Hospitals, Lelystad, The Netherlands.
17
Rheumatology Department, Hôpital Ambroise Paré (APHP), Boulogne-Billancourt, France.
18
INSERM U1173, Laboratoire d'Excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, Saint-Quentin en Yvelines, France.
19
EULAR PARE Patient Research Partner, Amsterdam, The Netherlands.
20
Leeds Teaching Hospitals NHS Trust, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK.
21
Joint and Bone Center for Diagnosis, Research, and Therapy of Musculoskeletal Disorders, Medical University of Vienna, Vienna, Austria.
22
Immanuel Krankenhaus Berlin, Medical Center for Rheumatology, Berlin, Germany.
23
Dipartimento Scienze Cliniche e Biologiche - Reumatologia, Università degli Studi di Torino, Turin, Italy.
24
Department of Internal Medicine, Mikkeli Central Hospital, Mikkeli, Finland.
25
Department of Medicine-Rheumatology, Trinity College, Dublin, Ireland.
26
Department of Internal Medicine, "Iuliu Hatieganu", University of Medicine and Pharmacy, Cluj-Napoca, Romania.
27
Department of Rheumatology, University of Sherbrooke, Québec, Canada.
28
Division of Rheumatology, 3rd Department of Internal Medicine, Medical University of Vienna, Vienna, Austria.
29
Division of Rheumatology, University of Florida College of Medicine, Jacksonville, Florida, USA.
30
Rheumatology Division, 2nd Rehabilitation Department, Rehabilitation Clinical Hospital, Cluj-Napoca, Romania.
31
Rheumatology and Clinical Immunology Division, University of Hong Kong, Hong Kong SAR, China.
32
Department of Rheumatology, Sf. Maria Clinical Hospital, Bucharest, Romania.
33
Department of Biomedical Research, Universidad Autónoma de Aguascalientes, Aguascalientes, México.
34
Department of Medicine, Surgery and Neurosciences, Rheumatology Section, University of Siena, Siena, Italy.
35
Department of Rheumatology, Medicarte, Medellín, Colombia.
36
Rheumatology Centre 'St Irina', Sofia, Bulgaria.
37
Department of Rheumatology, Universidad de Los Andes, Mérida, Venezuela.
38
Instituto de Salud Musculoesquelética (InMusc), Madrid, Spain.
39
Department of Rheumatology, Joint and Bone Research Unit, Hospital Universitario Fundación Jiménez Díaz and Autónoma University, Madrid, Spain.

Abstract

BACKGROUND:

In 2001, the European League Against Rheumatism developed and disseminated the first guidelines for musculoskeletal (MS) ultrasound (US) in rheumatology. Fifteen years later, the dramatic expansion of new data on MSUS in the literature coupled with technological developments in US imaging has necessitated an update of these guidelines.

OBJECTIVES:

To update the existing MSUS guidelines in rheumatology as well as to extend their scope to other anatomic structures relevant for rheumatology.

METHODS:

The project consisted of the following steps: (1) a systematic literature review of MSUS evaluable structures; (2) a Delphi survey among rheumatologist and radiologist experts in MSUS to select MS and non-MS anatomic structures evaluable by US that are relevant to rheumatology, to select abnormalities evaluable by US and to prioritise these pathologies for rheumatology and (3) a nominal group technique to achieve consensus on the US scanning procedures and to produce an electronic illustrated manual (ie, App of these procedures).

RESULTS:

Structures from nine MS and non-MS areas (ie, shoulder, elbow, wrist and hand, hip, knee, ankle and foot, peripheral nerves, salivary glands and vessels) were selected for MSUS in rheumatic and musculoskeletal diseases (RMD) and their detailed scanning procedures (ie, patient position, probe placement, scanning method and bony/other landmarks) were used to produce the App. In addition, US evaluable abnormalities present in RMD for each anatomic structure and their relevance for rheumatology were agreed on by the MSUS experts.

CONCLUSIONS:

This task force has produced a consensus-based comprehensive and practical framework on standardised procedures for MSUS imaging in rheumatology.

KEYWORDS:

procedures; rheumatic and musculoskeletal diseases; rheumatology; scanning; standardization; ultrasound

PMID:
28814430
DOI:
10.1136/annrheumdis-2017-211585
[Indexed for MEDLINE]

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