骨骼肌肉超音波－風濕科醫師擴展理學檢查能力之手

Musculoskeletal ultrasound (MSUS) allows high-resolution, real-time imaging of articular and periarticular structures and is routinely used by an increasing number of rheumatologists in rheumatological practice. There is now accumulating evidence that MSUS improves clinical diagnosis and intervention skills. MSUS is superior to clinical examination in the diagnosis and localization of joint and bursal effusion and synovitis. MSUS is the imaging modality of choice for the diagnosis of tendon pathology. MSUS is seven times more sensitive than plain radiography in the detection of rheumatoid erosions, allowing earlier diagnosis of progressive rheumatoid arthritis. Ligament, muscle, peripheral nerve and cartilage pathology can also be readily demonstrated by MSUS. There is exciting evidence that not only joint and muscle disease but also scleroderma, vasculitis and Sjögren's syndrome may be diagnosed by MSUS potentially. Joint aspiration and injection accuracy can be improved by MSUS, with initial evidence confirming improved efficacy. There is likely to be a growing number of proven clinical indications for the application of MSUS in rheumatology practice due to the increasing number of rheumatologists performing MSUS and the improving technical capabilities of MSUS. This paper reviews the evidence for the application of MSUS in rheumatologic diseases.