Validación de la ecografía musculoesquelética en la evaluación de diferentes aspectos de la artritis reumatoide

Résumé

In recent years, remission has become a realistic therapeutic goal in rheumatoid arthritis (RA) management thanks to early diagnosis and treatment, effective drugs, both old and new, tight clinical control and the treat-to-target concept [1,2]. In this current scenario, therapeutic decisions should target sustained remission in RA clinical practice. Thus, accurate assessment of remission state is of utmost importance for therapeutic decision-making regarding RA patients.Remission in RA can be established and measured by different instruments [eg. Disease Activity Score (DAS), DAS 28, Simple Disease Activity Index (SDAI), Clinical Disease Activity Index (CDAI)] or by the new remission criteria in RA by the ACR and European League Against Rheumatism (EULAR) [1]. These instruments are either criteria or composite scores, which are combinations of clinical and laboratory parameters surrogates for inflammation. However, clinical parameters (eg. tender and swollen joints) may not accurately reflect real joint synovitis in RA patients. Over the last decade, musculoskeletal ultrasound (US) on B-mode has widely demonstrated greater sensitivity than clinical assessment for detecting synovitis and tenosynovitis in RA target joints. Moreover, US on Doppler mode detects pathological synovial blood flow, which reflects joint inflammatory activity...