While new recommendations suggest early aggressive management of rheumatoid arthritis, our ability to assess treatment response is limited to clinical and…

Ultrasound at point-of-care is standard-of-care in any rheumatology practice today. It allows for early detection of synovitis for timely intervention, and informs response monitoring and tapering decision-making.

Objective To evaluate the prevalence of joint inflammatory abnormalities and erosions detected by grey-scale and Doppler ultrasound (US) in the small joints of hands and feet in healthy subjects.

In this sonographic study in healthy adults, abnormalities are mild and confined mainly to the toe joints especially MTPJ1. This does not detract from ultrasound’s unsurpassed utility in detecting early synovitis. It truly is the modern rheumatologist’s stethoscope.

Appropriate measures of disease activity need to be valid, reliable and sensitive to change for use in clinical studies while remaining at the same time feasible and practicable for utilization in daily clinical practice. Ultrasonography was shown to be a valid, sensitive and reliable imaging modali…

Can and should we move to a Treat-to-sonographic-remission-Target in RA? Yes, No, Maybe-Not-Yet. Read on.


Contributors All the authors are members of the are members of the TUI group project. All the authors contributed to the conception and drafting of the article.


Abstracts of the 2013 American College of Rheumatology/Association of Rheumatology Health…


Disease Markers is a peer-reviewed, open access journal that publishes original research articles, review articles, and clinical studies related to all aspects of disease markers.
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PDUS seems a logical adjunct (a more accurate criterion perhaps) to clinical measures of disease activity in RA and other inflammatory arthritides: it can detect subclinical disease (beyond pain and systemic inflammatory markers), and circumvent patient outcome measures not due to inflammation (eg damage, degeneration, fibromyalgia). But the jury is still out as to its sensitivity (or over-sensitivity) to change and the inadequacy of assessment standardisation. For now, its usefulness is far less disputed in the early detection of inflammation, and (in my subsequent post) in informing biologic tapering/withdrawal.

Don’t Taper RA Meds Before Checking Doppler for Synovitis

DAS28 and Doppler scores predict biological therapy failure.