Ultrasound is an accurate technique for detecting synovitis, an inflammation of the joint lining, in wrists and fingers. So conclude Kaoru Takase-Minegishi, of Yokohama City University Medical Center, and colleagues writing in a review and meta-analysis published in Rheumatology.

“It may be considered for routine use as part of the standard diagnostic tools in rheumatoid arthritis,” they add.

The scholars identified 601 articles, of which they culled 14 which they included in the review. Six of the 14 came from Japan, four were from Denmark, and one each came from Belgium, China, Germany, and the UK.

Writing in Rheumatology Network, cardiothoracic anesthesiologist Gregory Weiss, of Carilion Roanoke Memorial Hospital in Virginia, noted four implications for physicians, including the relatively inexpensive cost of ultrasound compared to MRI. But, he added, it’s probably not the method of choice for knee synovitis.

In the analysis, Takase-Minegishi and colleagues note that the primary goal for treating rheumatoid arthritis is to achieve remission as quickly as possible, and that is best accomplished with early diagnosis and treatment.

“Recently, advances in the field of imaging techniques have resulted in ultrasound and MRI being recommended for diagnosing and monitoring disease activity in rheumatoid arthritis patients,” they write. “Ultrasound and MRI have been shown to be more sensitive than clinical examination in detecting synovitis, both in active disease and in remission.”

Whereas it can be time consuming and expensive to assess multiple joints using MRI, ultrasound is “relatively low cost, non-invasive and has real-time capabilities and portability,” the researchers write.

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