Ultrasound in vasculitis
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Role of ultrasound in the understanding and management of vasculitis
Ultrasonography of Large-Vessel Vasculitides
Takayasu Arteritis Imaging: Overview, Radiography, Ultrasonography
Assessment of Takayasu Arteritis Activity by Carotid Contrast-Enhanced Ultrasound
Diagnostic validity of Doppler ultrasound in giant cell arteritis
Ultrasound-Based Vasculitis Diagnosis May Save Vision
Rheumatological ultrasound is more than just musculoskeletal ultrasound (MSUS). The latter finds its proponents among sports physicians, orthopods, physiatrists and physiotherapists. The rheumatologists’ special interest and expertise in MSUS is in the inflammatory arthritides.
As evident in my earlier posts, rheumatologists are also interested in sounding salivary glands, lymph nodes, lungs and skin. Today, we take a look at blood vessels. All these emerging niche areas pertain to the range of systemic connective tissue diseases.
Among the vasculitides, the best studied using ultrasound are the large vessel arteritis, namely: Takayasu Arteritis and Giant Cell Arteritis. These 2 are particularly hard to diagnose and to monitor. Hard to diagnose because they lack specific serologies, lesions may be skipped, and the large blood vessels are not readily amenable to biopsy. Hard to monitor as inflammatory markers don’t always reflect disease activity, and it is often difficult to differentiate the latter from old damage.
Imaging is therefore the mainstay. If ultrasound can be reliably refined for diagnosis and monitoring, then much cost and radiation (think PET & CT scans) can be saved in routine practice. We’re getting there.