Ultrasound is a highly sensitive tool in demonstrating high definition structural changes in soft tissues such as synovium, tendons and muscle and in bone and cartilage. Multiple studies have confirmed that ultrasound is more sensitive than clinical examination in the detection of synovial inflammation and joint effusion in both small and large joints and also in the detection of tendonitis, tenosynovitis and enthesitis. Ultrasound findings have better interobserver reproducibility than clinical examination findings and have been validated by correlation with MRI, CT scintigraphy and histological techniques. These finding have been reproduced in patients with both early and late disease and by researchers of different levels of expertise and using equipment of varying technological standards. However gray scale and power Doppler ultrasound abnormalities of joint and soft tissues have been noted in normal asymptomatic populations and in patients with disease who meet remission criteria, leading to concerns as to how to distinguish normal from abnormal ultrasound findings. This lecture reviews the OMERACT definitions of ultrasound pathology, how they were defined and how effective they are in defining abnormality in clinical practice. The relevance of abnormal ultrasound findings in asymptomatic and remission populations in terms of prognosis and outcome is examined. The effect of ageing on ultrasound findings in joints of normal subjects is presented.
Disclosure of Interest None Declared
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