Download PDF
Orthopädie und Unfallchirurgie up2date 2016; 11(02): 141-156
DOI: 10.1055/s-0041-108638
Systemerkrankungen
Georg Thieme Verlag KG Stuttgart · New York

Ultraschalldiagnostik Rheuma

A.-M. Glimm   *
,
M. Henniger   *
,
M. Backhaus
,
S. Rehart
Further Information

Publication History

Publication Date:
17 March 2016 (online)

Also available at
    Permissions and Reprints All articles of this category

Die Arthrosonografie hat in der Rheumatologie einen hohen Stellenwert und stellt eine wichtige Ergänzung des klinischen Befunds dar. Sie wird in der Frühdiagnostik, zur Differenzialdiagnostik, aber auch als Prognoseparameter, zur Beurteilung der Krankheitsaktivität und zur Therapieüberwachung regelhaft eingesetzt.

Während mit der B-Mode-Sonografie typische entzündliche Befunde an Gelenken, Sehnen und periartikulär, wie Gelenkergüsse, synoviale Proliferationen, Tenosynovialitiden, Bursitiden und Erosionen, dargestellt werden können, dient die PD-(Power-Doppler-)Mode-Sonografie über die Messung der synovialen Hypervaskularisation der Beurteilung der Krankheitsaktivität. Es existieren verschiedene Scoring-Methoden zur Quantifizierung der Befunde mit dem Ziel, durch eine sonografische Untersuchung weniger, ausgewählter Gelenke und Sehnen das Therapieansprechen zu überwachen.

* geteilte Erstautorenschaft


 

  • Literatur

  • 1 Combe B, Landewe R, Lukas C et al. EULAR recommendations for the management of early arthritis: report of a task force of the European Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis 2007; 66: 34-45
    CrossrefPubMedGoogle Scholar
  • 2 Smolen JS, Landewe R, Breedveld FC et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Ann Rheum Dis 2010; 69: 964-975
    Google Scholar
  • 3 Aletaha D, Neogi T, Silman AJ et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 2010; 62: 2569-2581
    Google Scholar
  • 4 Strunk J. Brauchen wir im Jahr 2011 bildgebende Verfahren für die Diagnose einer rheumatoiden Arthritis? Stellenwert der Bildgebung in den neuen ACR/EULAR-Klassifikationskriterien der rheumatoiden Arthritis. Z Rheumatol 2011; 70: 183-184
    CrossrefPubMedGoogle Scholar
  • 5 Backhaus M, Kamradt T, Sandrock D et al. Arthritis of the finger joints: a comprehensive approach comparing conventional radiography, scintigraphy, ultrasound, and contrast-enhanced magnetic resonance imaging. Arthritis Rheum 1999; 42: 1232-1245
    CrossrefPubMedGoogle Scholar
  • 6 Dougados M, Devauchelle-Pensec V, Ferlet JF et al. The ability of synovitis to predict structural damage in rheumatoid arthritis: a comparative study between clinical examination and ultrasound. Ann Rheum Dis 2013; 72: 665-671
    CrossrefPubMedGoogle Scholar
  • 7 McGonagle D, Conaghan PG, OʼConnor P et al. The relationship between synovitis and bone changes in early untreated rheumatoid arthritis: a controlled magnetic resonance imaging study. Arthritis Rheum 1999; 42: 1706-1711
    CrossrefPubMedGoogle Scholar
  • 8 Ostergaard M, Hansen M, Stoltenberg M et al. Magnetic resonance imaging-determined synovial membrane volume as a marker of disease activity and a predictor of progressive joint destruction in the wrists of patients with rheumatoid arthritis. Arthritis Rheum 1999; 42: 918-929
    CrossrefPubMedGoogle Scholar
  • 9 Conaghan PG, McGonagle D, Wakefield R et al. New approaches to imaging of early rheumatoid arthritis. Clin Exp Rheumatol 1999; 17: S37-S42
    PubMedGoogle Scholar
  • 10 Schmidt WA, Schicke B, Ostendorf B et al. Low-field MRI versus ultrasound: which is more sensitive in detecting inflammation and bone damage in MCP and MTP joints in mild or moderate rheumatoid arthritis?. Clin Exp Rheumatol 2013; 31: 91-96
    PubMedGoogle Scholar
  • 11 Backhaus M, Burmester GR, Gerber T et al. Guidelines for musculoskeletal ultrasound in rheumatology. Ann Rheum Dis 2001; 60: 641-649
    CrossrefPubMedGoogle Scholar
  • 12 Backhaus M, Scheel AK, Burmester GR. Neue Entwicklungen in der Gelenksonographie. Z Rheumatol 2006; 65: 700-708
    CrossrefPubMedGoogle Scholar
  • 13 Strunk J. Sonografische Diagnostik in der Rheumatologie. Vol. 1. Bremen: UNI-MED Verlag; 2014
    Google Scholar
  • 14 Koenig MJ, Torp-Pedersen ST, Christensen R et al. Effect of knee position on ultrasound Doppler findings in patients with patellar tendon hyperaemia (jumperʼs knee). Ultraschall Med 2007; 28: 479-483
    Article in Thieme ConnectPubMedGoogle Scholar
  • 15 Joshua F, de Carle R, Rayment M et al. Power Doppler ‘blanching’ after the application of transducer pressure. Australas Radiol 2005; 49: 218-221
    CrossrefPubMedGoogle Scholar
  • 16 Ostendorf B, Scherer A, Kellner H et al. [Project REMISSION(PLUS): clinical and radiological remission: new treatment goals in the management of rheumatoid arthritis]. Z Rheumatol 2008; 67: 707-710 712–715
    CrossrefPubMedGoogle Scholar
  • 17 Farrant JM, OʼConnor PJ, Grainger AJ. Advanced imaging in rheumatoid arthritis. Part 1: synovitis. Skeletal Radiol 2007; 36: 269-279
    CrossrefPubMedGoogle Scholar
  • 18 Wakefield RJ, Balint PV, Szkudlarek M et al. Musculoskeletal ultrasound including definitions for ultrasonographic pathology. J Rheumatol 2005; 32: 2485-2487
    PubMedGoogle Scholar
  • 19 Grassi W, Filippucci E. Ultrasonography and the rheumatologist. Curr Opin Rheumatol 2007; 19: 55-60
    CrossrefPubMedGoogle Scholar
  • 20 Terslev L, Naredo E, Iagnocco A et al. Defining enthesitis in spondyloarthritis by ultrasound: results of a Delphi process and of a reliability reading exercise. Arthritis Care Res (Hoboken) 2014; 66: 741-748
    CrossrefPubMedGoogle Scholar
  • 21 Schmidt WA. Sonografie in der Früherkennung und Bewertung von Arthritiden. arthritis + rheuma 2015; 35: 7-10
    PubMedGoogle Scholar
  • 22 Schneider M, Krüger K. Rheumatoide Arthritis – Frühdiagnose und Krankheitskontrolle. Dtsch Ärztebl Int 2013; 110: 477-484
    PubMedGoogle Scholar
  • 23 Schneider M, Lelgemann M, Abholz H et al. Management der frühen rheumatoiden Arthritis. Heidelberg: Springer; 2011
    Google Scholar
  • 24 Iagnocco A, Naredo E, Wakefield R et al. Responsiveness in rheumatoid arthritis. A report from the OMERACT 11 ultrasound workshop. J Rheumatol 2014; 41: 379-382
    CrossrefPubMedGoogle Scholar
  • 25 Szkudlarek M, Court-Payen M, Jacobsen S et al. Interobserver agreement in ultrasonography of the finger and toe joints in rheumatoid arthritis. Arthritis Rheum 2003; 48: 955-962
    CrossrefPubMedGoogle Scholar
  • 26 Colebatch AN, Edwards CJ, Ostergaard M et al. EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis. Ann Rheum Dis 2013; 72: 804-808
    CrossrefPubMedGoogle Scholar
  • 27 Lillegraven S, Boyesen P, Hammer HB et al. Tenosynovitis of the extensor carpi ulnaris tendon predicts erosive progression in early rheumatoid arthritis. Ann Rheum Dis 2011; 70: 2049-2050
    CrossrefPubMedGoogle Scholar
  • 28 Scheel AK, Hermann KG, Kahler E et al. A novel ultrasonographic synovitis scoring system suitable for analyzing finger joint inflammation in rheumatoid arthritis. Arthritis Rheum 2005; 52: 733-743
    CrossrefPubMedGoogle Scholar
  • 29 Naredo E, Gamero F, Bonilla G et al. Ultrasonographic assessment of inflammatory activity in rheumatoid arthritis: comparison of extended versus reduced joint evaluation. Clin Exp Rheumatol 2005; 23: 881-884
    PubMedGoogle Scholar
  • 30 Dougados M, Jousse-Joulin S, Mistretta F et al. Evaluation of several ultrasonography scoring systems for synovitis and comparison to clinical examination: results from a prospective multicentre study of rheumatoid arthritis. Ann Rheum Dis 2010; 69: 828-833
    CrossrefPubMedGoogle Scholar
  • 31 Ellegaard K, Torp-Pedersen S, Terslev L et al. Ultrasound colour Doppler measurements in a single joint as measure of disease activity in patients with rheumatoid arthritis – assessment of concurrent validity. Rheumatology (Oxford) 2009; 48: 254-257
    PubMedGoogle Scholar
  • 32 Hartung W, Kellner H, Strunk J et al. Development and evaluation of a novel ultrasound score for large joints in rheumatoid arthritis: one year of experience in daily clinical practice. Arthritis Care Res 2012; 64: 675-682
    CrossrefPubMedGoogle Scholar
  • 33 Schäfer VS, Fleck M, Kellner H et al. Evaluation of the novel ultrasound score for large joints in psoriatic arthritis and ankylosing spondylitis: six month experience in daily clinical practice. BMC Musculoskelet Disord 2013; 14: 358
    CrossrefPubMedGoogle Scholar
  • 34 Naredo E, DʼAgostino MA, Wakefield RJ et al. Reliability of a consensus-based ultrasound score for tenosynovitis in rheumatoid arthritis. Ann Rheum Dis 2013; 72: 1328-1334
    CrossrefPubMedGoogle Scholar
  • 35 Bruyn GA, Hanova P, Iagnocco A et al. Ultrasound definition of tendon damage in patients with rheumatoid arthritis. Results of a OMERACT consensus-based ultrasound score focussing on the diagnostic reliability. Ann Rheum Dis 2014; 73: 1929-1934
    CrossrefPubMedGoogle Scholar
  • 36 Szkudlarek M, Court-Payen M, Strandberg C et al. Contrast-enhanced power Doppler ultrasonography of the metacarpophalangeal joints in rheumatoid arthritis. Eur Radiol 2003; 13: 163-168
    PubMedGoogle Scholar
  • 37 Backhaus M, Ohrndorf S, Kellner H et al. Evaluation of a novel 7-joint ultrasound score in daily rheumatologic practice: a pilot project. Arthritis Rheum 2009; 61: 1194-1201
    CrossrefPubMedGoogle Scholar
  • 38 Ohrndorf S, Fischer IU, Kellner H et al. Reliability of the novel 7-joint ultrasound score: results from an inter- and intraobserver study performed by rheumatologists. Arthritis Care Res 2012; 64: 1238-1243
    PubMedGoogle Scholar
  • 39 Backhaus TM, Ohrndorf S, Kellner H et al. The US7 score is sensitive to change in a large cohort of patients with rheumatoid arthritis over 12 months of therapy. Ann Rheum Dis 2013; 72: 1163-1169
    CrossrefPubMedGoogle Scholar
  • 40 Hammer HB, Kvien TK. Comparisons of 7- to 78-joint ultrasonography scores: all different joint combinations show equal response to adalimumab treatment in patients with rheumatoid arthritis. Arthritis Res Ther 2011; 13: R78
    CrossrefPubMedGoogle Scholar