Article Text

other Versions

Download PDFPDF
Back to the future: forget ultrasound and focus on clinical assessment in rheumatoid arthritis management
  1. Roberto Caporali1,
  2. Josef S Smolen2
  1. 1Division of Rheumatology, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
  2. 2Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria
  1. Correspondence to Professor Roberto Caporali, IRCCS Policlinico S. Matteo Foundation, Pz.le Golgi 2, Pavia, Italy; caporali{at}


Ultrasound (US) unquestionably improves many aspects of rheumatoid arthritis (RA) diagnosis and management, but no consensus has been reached regarding the optimal US methodology that should be used, and high levels of standardisation have not yet been attained. Current evidence from two randomised controlled trials does not support the US in directing treatment decisions. A return to the endorsement of clinical assessment and the adoption of T2T strategies aiming at ACR/EULAR remission still represent the standard of care for RA and should be pursued through appropriate educational programmes. Thus, for now, the major application of sonography in arthritis should have a focus on diagnostic and especially differential diagnostic aspects.

  • rheumatoid arthritis
  • ultrasonography
  • disease activity score
  • remission

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors Both the authors gave substantial contributions to the conception of the paper as well as drafting the paper and revising it critically for important intellectual content. They gave final approval of the version to be submitted.

  • Disclaimer JS has received grants for his institution from Abbvie, Astra-Zeneca, Janssen, Lilly, MSD, Pfizer, Roche and has provided expert advice to and/or had speaking engagements for Abbvie, Amgen, Astra-Zeneca, Astro, BMS, Celgene, Celltrion, Chugai, Gilead, Glaxo, ILTOO, Janssen, Lilly, Medimmune, MSD, Novartis-Sandoz, Pfizer, Roche, Samsung, Sanofi, UCB. RC has provided expert advice to and/or had speaking engagements for Abbvie, BMS, Celgene, Celltrion, Janssen, Lilly, MSD, Mundipharma, Novartis-Sandoz, Pfizer, Roche, Sanofi, UCB.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.