The absence of specific guidance on how to use ultrasound (US) to diagnose and manage patients with inflammatory arthritis, especially with rheumatoid arthritis (RA) has hindered the optimal utilisation of US in clinical practice, potentially limiting its benefits for patient outcomes. In view of this, a group of musculoskeletal US experts formed a working group to consider how this unmet need could be satisfied and to produce guidance (additional to European League against Rheumatism (EULAR) imaging recommendations) to support clinicians in their daily clinical work. This paper describes this process and its outcome, namely five novel algorithms, which identify when US could be used. They are designed to aid diagnosis, to inform assessment of treatment response/disease monitoring and to evaluate stable disease state or remission in patients with suspected or established RA, by providing a pragmatic template for using US at certain time points of the RA management. A research agenda has also been defined for answering unmet clinical needs.
- Rheumatoid Arthritis
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Handling editor Tore K Kvien
Contributors MADA and PE substantially contributed to the conception and design of the work, the acquisition, analysis and interpretation of data, drafting the work and revising it critically for important intellectual content. LT, RW, MØ, EN, AI, WG contributed to the analysis and interpretation of data, drafting the work and revising it critically for important intellectual content. Final approval of the version published was done by all authors.
Funding AbbVie provided an independent grant to the University of Leeds to support the development of this paper. Medical writing and meeting organisation was provided by Patient Central. The authors of this paper are members of the independent TUI Steering Committee, which has previously received support from AbbVie.
Competing interests PE has undertaken clinical trials and provided expert advice to Pfizer, MSD, Abbvie, BMS, UCB, Roche, Novartis, Samsung, Sandoz and Lilly. MADA has received speaker bureau from MSD, Abbvie, BMS, UCB, Roche and Novartis.
Provenance and peer review Not commissioned; externally peer reviewed.