ROLE OF ULTRASONOGRAPHY IN DIFFERENTIAL DIAGNOSIS OF EARLY ARTHRITIS

The article is devoted to the application of ultrasound in the differential diagnosis of early arthritis. The authors present a brief history of sonography use in rheumatology. The article characterizes imaging standards of The European League Against Rheumatism (The European Alliance of Associations for Rheumatology) working group on musculoskeletal ultrasound. The authors outline the advantages of ultrasound over other methods of visualization used by rheumatologists in the diagnosis of arthritis, including cost-effectiveness, accessibility, safety, and the ability to perform real-time multidimensional and dynamic assessment of joints. The article presents the consensual definitions of common sonographic pathological changes in rheumatic diseases described by the Ultrasound Working Group, including synovitis, enthesitis, tenosynovitis, tendon damage, bone erosions, osteophytes, cartilage damage, and crystal deposition. The authors discuss the difficulty in diagnosing of early arthritis with ambiguous findings of clinical examination, laboratory tests, and X-ray. The article describes the ultrasound signs of joint lesions in rheumatoid arthritis, spondyloarthritis, microcrystalline arthritis, osteoarthritis, and systemic connective tissue diseases. Special attention is paid to differential diagnosis between various types of early arthritis. The authors substantiate the importance of using ultrasound in identifying early arthritis as an additional method of imaging.

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