Recommendations for the use of ultrasound and magnetic resonance in patients with rheumatoid arthritis

Reumatol Clin (Engl Ed). 2018 Jan-Feb;14(1):9-19. doi: 10.1016/j.reuma.2016.08.010. Epub 2016 Oct 29.
[Article in English, Spanish]

Abstract

Objective: To develop evidence-based recommendations on the use of ultrasound (US) and magnetic resonance imaging (MRI) in patients with rheumatoid arthritis (RA).

Methods: Recommendations were generated following a nominal group technique. A panel of experts, consisting of 15 rheumatologists and 3 radiologists, was established in the first panel meeting to define the scope and purpose of the consensus document, as well as chapters, potential recommendations and systematic literature reviews (we used and updated those from previous EULAR documents). A first draft of recommendations and text was generated. Then, an electronic Delphi process (2 rounds) was carried out. Recommendations were voted from 1 (total disagreement) to 10 (total agreement). We defined agreement if at least 70% of experts voted ≥7. The level of evidence and grade or recommendation was assessed using the Oxford Centre for Evidence-based Medicine Levels of Evidence. The full text was circulated and reviewed by the panel. The consensus was coordinated by an expert methodologist.

Results: A total of 20 recommendations were proposed. They include the validity of US and MRI regarding inflammation and damage detection, diagnosis, prediction (structural damage progression, flare, treatment response, etc.), monitoring and the use of US guided injections/biopsies.

Conclusions: These recommendations will help clinicians use US and MRI in RA patients.

Keywords: Artritis reumatoide; Ecografía; Magnetic resonance; Recomendaciones; Recommendations; Resonancia magnética; Rheumatoid arthritis; Ultrasound.

Publication types

  • Practice Guideline

MeSH terms

  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / diagnostic imaging*
  • Arthritis, Rheumatoid / drug therapy
  • Delphi Technique
  • Drug Monitoring
  • Evidence-Based Medicine
  • Humans
  • Magnetic Resonance Imaging*
  • Ultrasonography

Substances

  • Antirheumatic Agents