Ultrasound in practice
How might ultrasound add value to aid diagnosis, assessment of therapeutic response and the assessment of disease state?
Scenario 1: Minimal grey scale in wrist
Non-significant inflammation, possibly element of overuse in benign hypermobility. Suggested management: conservative (splint +/- intra-articular injection, exercise advice)
Scenario 2: Grade 2 grey scale and grade 2 power Doppler (PD) in both ulnar carpal joints + mild erosive change of the ulna styloids bilaterally?
Evolving inflammatory arthritis – risk of persistent erosive arthritis – grade 2 PD and erosions. Suggested management: conventional sDMARD (csDMARD) +/- intra-articular injection
Changed diagnosis and management
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