The ultrasonography in rheumatology: A before and after

Within the last 20 years, the development of high frequency transducers, which have greatly improved musculoskeletal US imaging has led to a widespread use of ultrasonography as a diagnostic and therapeutic technique in rheumatology. Sonography has become a powerful diagnostic and research tool in clinical rheumatology that adds valuable information simultaneously to clinical evaluation. The incorporation of ultrasound to rheumatology has been a logical extension of its established practice in other specialities such as obstetrics, gynecology and cardiology. High-resolution musculoskeletal ultrasonography is a valid and reliable method for assessing peri articular and intra-articular anatomic structures involved in rheumatic disease. Ultrasonography has considerable advantages over other imaging modalities including non-invasiveness, speed of performance, relative low cost, and ability to scan multiple joints, repeatability and high patient acceptability. Musculoskeletal dynamic examination in real time can be performed routinely, which shows the movement of tendons and muscles and aids the detection of abnormalities. In addition, ultrasound can be used for guidance of musculoskeletal injections and biopsies. Last but not least, rheumatologists can undertake in-office MSUS, avoiding referral to radiologists and saving time and money