Ultrasound is critical in rheumatology because it is an excellent support in diagnosis, especially in differential diagnostics.

It is also helpful during the treatments, such as infiltrations, and in the follow-up of patients who have already developed rheumatologic disease. It can also be administered in a clinic directly by the physician.

Ultrasound in Differential Diagnosis

Ultrasound is essential for differential diagnosis, for example, when the patient complains of arthropathy at its onset or in the differential diagnosis between arthritis and arthrosis, thus between an inflammatory and degenerative pathology.

By assessing the area affected by inflammation with ultrasound, the physician can tell early, even before the disease is clinically active, whether there are signs of inflammation or recurrence. 

Ultrasound is a non-invasive, easily reproducible method and can also be performed in a clinic, unlike other procedures such as, for example, MRI or CT scans. It is a dynamic examination that, in the case of rheumatology, fits into the broader set of muscle-tendon ultrasounds. Ultrasound aims at evaluating the diagnostic question; therefore, depending on the issue highlighted by the ultrasound, the patient is guided to the most appropriate specialist. 

Ultrasound is also a method to diagnose diseases such as rheumatoid arthritis

Treatment, Follow-up, and Intervention: The Usefulness of Ultrasound

During the treatment, ultrasound is helpful as it allows the assessment of disease activity. It is mainly used in the setting of inflammatory arthropathies, thus arthritis, even at early stages. 

Sometimes, the disease can appear to be under apparent reasonable clinical control, but, despite this, the patient continues to report pain: an ultrasound allows us to understand whether the underlying cause of the pain is a flare-up of the disease or has to do with another disorder, as in the case of tendonitis

In case of pain, the ultrasound directs the specialist’s choice of therapy and, even once the disorder has been treated, allows the physician to continue to assess disease activity during the follow-up. 

Ultrasound is also very supportive in interventional procedures because it can guide specific invasive procedures, such as infiltrations