New Draft Ultrasound Guidance for Inflammatory Arthritis

As the role of musculoskeletal ultrasound evolves in the clinical diagnosis and monitoring of rheumatic disease, an ACR-supported team is updating guidance for the use of this imaging for inflammatory arthritis.

In the session ACR Musculoskeletal Ultrasound Guidance Update for Inflammatory Arthritis, presenters will highlight the drafted recommendations, including their rationale, and discuss practical application of the guidance in day-to-day practice.

“Despite musculoskeletal ultrasound becoming more prevalent amongst rheumatologists and significant advances in ultrasound technology, the ACR guidance has not been updated since 2012,” said Erin Chew, MD, Vanderbilt University Medical Center, one of the session moderators. “This guidance is focused on creating an evidence-based synthesis of the use of ultrasound in rheumatoid arthritis (RA) and psoriatic arthritis (PsA), specifically.”

The session will begin on Sunday, Nov. 12, at 11 a.m. PT in Room 31A–C of the San Diego Convention Center. It will be available on demand within 24 hours for registered ACR Convergence 2023 participants.

“Attendees will learn about the process involved in updating the guidance and landmark studies that may influence the update,” Dr. Chew said. “Experts will teach attendees about the best practices to design ultrasound studies for inflammatory arthritis, how ultrasound has transformed treatment management in RA beyond ‘treat to target,’ and how ultrasound can assist diagnosis and management of psoriatic arthritis.”

Veena K. Ranganath, MD, MS, RhMSUS, Clinical Professor, Division of Rheumatology, at the University of California, Los Angeles, will discuss best practices to obtain reliable and reproducible ultrasound studies for inflammatory arthritis.

Gurjit Kaeley, MBBS, RhMSUS, MRCP, Division Chief, Professor of Medicine, Fellowship Program Director and Program Director for Musculoskeletal Ultrasound at the University of Florida College of Medicine, Jacksonville, will present information on ultrasound use in RA.

Catherine Bakewell, MD, RhMSUS, who practices general adult rheumatology at Intermountain Healthcare, will discuss ultrasound use in the evaluation and management of psoriatic arthritis.

Based on a systematic review of the literature, the session will:

• Identify which inflammatory and structural damage features on ultrasound predict early RA and PsA;
• Explain the capabilities of musculoskeletal ultrasound to differentiate between inflammatory and non-inflammatory sources of symptoms in patients with RA and PsA;
• Consider whether musculoskeletal ultrasound allows for better assessment of disease activity to enhance shared decision-making; and
• Discuss whether musculoskeletal ultrasound can inform shared decision-making in patients in clinical remission.

“All rheumatologists should be aware of the indications for musculoskeletal ultrasound and how it can assist assessment of disease activity or early diagnosis so that they can refer early to a rheumatologist trained in musculoskeletal ultrasound,” Dr. Chew said.