Ultrasound imaging in spondyloathropathies: from imaging to diagnostic intervention

Ultrasound has developed significantly over the past decade, becoming a potent imaging modality for the assessment of inflammatory arthritis. Until recently, few published data were available with respect to the use of ultrasound imaging in patients with spondyloarthropathy. This review examines the current state of ultrasound imaging with respect to spondyloarthritis and describes some of the limitations that need to be addressed.

Ultrasound imaging has been shown to be more sensitive than clinical examination in detecting many features of spondyloarthritis, such as synovitis and enthesitis. The ability to detect subclinical disease and demonstrate a clear response to therapeutic intervention makes this imaging modality a potential tool for both diagnostic and monitoring purposes. Despite this, a number of issues including a lack of standardization of ultrasound assessment of musculoskeletal disorders continue to hamper its progress. New three-dimensional technology is a promising development, which may allow this problem to be addressed.

Improving the ability of the rheumatologist to predict prognosis and guide therapeutic intervention is a long-term goal to which ultrasound may be able to provide a significant contribution. The addition of a novel imaging modality to currently available assessment tools may provide rheumatologists with a more precise working framework, which may be exploited for the benefits of the patients.