Musculoskeletal Ultrasonography in Rheumatic Diseases

Transcription

1 Musculoskeletal Ultrasonography in Rheumatic Diseases

2 Yasser El Miedany Editor Musculoskeletal Ultrasonography in Rheumatic Diseases 1 3

3 Editor Yasser El Miedany, MD, FRCP Department of Rheumatology Darent Valley Hospital Dartford, UK ISBN DOI / ISBN (ebook) Library of Congress Control Number: Springer Cham Heidelberg New York Dordrecht London Springer International Publishing Switzerland 2015 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper Springer is part of Springer Science+Business Media (

4 To my inspiring mom and dad for passing on the love of reading and the eagerness for learning To my family for their love, care, and encouragement

5 Foreword There are many challenges to providing a high quality musculoskeletal diagnostic and treatment service. Much of our diagnostic approach has relied traditionally on the skills of history and examination. These remain important, but are open to subjective interpretation. The same is true of assessing response to interventions, some of which are extremely expensive, and we need to justify their use with reliable methods of demonstrating improvement in the patient. We are working in health care systems where value (better outcomes at lower costs) is an increasingly important consideration. Against this background, ultrasound has increasingly become a part of the armory of the musculoskeletal practitioner. It helps us in diagnosis, treatment, and assessing response to interventions; to make musculoskeletal disease management more selective and objective, and improves the chances of the patient getting the right treatment from the right person and at the right time; to enhance our expertise and differentiate ourselves from other musculoskeletal practitioners. In summary, ultrasound helps musculoskeletal practitioners to improve value in health care, and possessing the skill of using this modality places the practitioner in a stronger position when it comes to the commissioning of high quality musculoskeletal services. All musculoskeletal practitioners should have the opportunity to train in developing expertise in this area. Some people in musculoskeletal practice talk well about their service, but do not always deliver. Yasser El Miedany does not fit into this category. I have always been impressed by his ability to take great ideas and translate them into living practice in high quality services that we can all learn from. It comes as no surprise, therefore, that he has managed to assemble an international collection of ultrasound experts, encyclopedically covering all areas of musculoskeletal disease and practice. There is much we can all learn from the contents of these chapters. I commend this book to all musculoskeletal practitioners. Chris Deighton BMedSci (Hons) MB BS (Hons) MD FRCP President of the British Society for Rheumatology Clinical Advisor National Institute of Health and Care Excellence Rheumatoid Arthritis Management Guidelines Consultant Rheumatologist, Derby, UK Associate Professor, Nottingham Medical School, UK vii

6 Preface The use of musculoskeletal ultrasonography in rheumatology clinical practice has expanded swiftly over the past decade as an outcome of the technological developments and implementation of the window of opportunity concept in most of the inflammatory musculoskeletal conditions. Ultrasound booked its place as the rheumatologist s stethoscope as it enabled the treating health care professional to diagnose, prognosticate, monitor disease activity as well as response to management. In contrast with other imaging modalities such as X-ray and magnetic resonance, ultrasound has clear advantages, namely good tolerability, no radioactivity, ability to scan both joints and soft tissue at one sitting and its dynamic facility, which enables direct correlation between clinical and imaging outcomes. In spite of some concerns regarding standardization, the use of ultrasound in rheumatology is expected to grow further as prices of the machine fall and the opportunity to practice improves. This book will go beyond the traditional specific joint ultrasonography, which has already been discussed thoroughly in previous publications, to focus on ultrasonographic changes in different musculoskeletal disorders. The main purpose of this book is to serve as a guide for any physician who wishes to perform clinical musculoskeletal ultrasound regardless of experience. The aim is provide a practical approach to dealing with patients suffering from different rheumatic diseases in standard practice. It is therefore suitable to a wide range of audience from the novice embarking on providing a musculoskeletal ultrasonography service, to the experienced who wishes to develop their sonographic scanning skills. The main theme of this book is to deliver a very practical and reader-friendly guide. On one hand it describes a how to do it approach, whereas in the meantime it delivers the evidence and advanced knowledge base of the relevant pathological sonographic appearances of the various musculoskeletal tissues. The illustrations and figures were meticulously selected to give the reader a clear guide towards implementation in real life practice. Focusing on the major values of ultrasound in rheumatologic diseases, this book with its 14 chapters is expected to fill an important void in the current literature. It represents what can be considered to be the best current thinking on role of ultrasonography in the assessment of pathology, diagnosis, and treatment of different rheumatic diseases. Therefore, this book can serve as both excellent introductory and a very good reference resource for future reading. ix

7 x Preface This work has been the outcome of cooperative effort of a large international group of leaders in musculoskeletal ultrasonography. They have done a superb job to produce authoritative chapters including vast amounts of scientific and clinical data to create state-of-the-art descriptions of sonographic changes encompassed by different rheumatic diseases. Special thanks to Dr. Chris Deighton who wrote the book s foreword and Dr. Adham Khalil for his support throughout the whole project which helped to make this book complete. Personally, I feel privileged to have compiled this work and am enthusiastic about all that it offers our readers. I hope you too will find this edition a uniquely valuable educational resource. Kent, England, UK Yasser El Miedany, MD FRCP Professor of Rheumatology and Rehabilitation (Egypt)/ Consultant Rheumatologist, UK

8 Contents 1 Fundamentals of Musculoskeletal Ultrasound... 1 Hatem El-Azizi MD, PhD and Carolina Botar Jid MD 2 Pitfalls in Musculoskeletal Ultrasound Violeta Maria Vlad MD, PhD 3 Rheumatoid Arthritis Esperanza Naredo MD, María Montoro MD and Iustina Janţă MD 4 Ankylosing Spondylitis Marina Backhaus MD and Yasser El Miedany MD, FRCP 5 Psoriatic Arthritis Carlos Acebes PhD and John P. Harvie MD 6 Osteoarthritis Annamaria Iagnocco MD and Vasilia Iorgoveanu MD 7 Crystal-Induced Arthritis Rodina Nestorova MD and Daniela Fodor MD, PhD 8 Skin, Nail, and Hair in Rheumatology Ximena Wortsman MD 9 Pediatric Musculoskeletal Disorders Paz Collado Ramos MD, PhD and Eva Álvarez Andrés MD 10 Carpal Tunnel Syndrome Yasser El Miedany MD, FRCP xi

9 xii Contents 11 Soft Tissue Rheumatism Adham Aboul Fotouh Khalil MD, MSc and Cristina Hernández-Díaz MD, MS 12 Inflammatory Allied Conditions Margarida Alexandre Oliveira MD and Anna Ciechomska MD, PhD 13 Sports Medicine Zbigniew Czyrny MD 14 Ultrasound-Guided Interventional Maneuvers Mihaela C. Micu MD and Daniela Fodor MD, PhD Index

10 Contributors Carlos Acebes, PhD Department of Rheumatology, Raigmore Hospital, Inverness, Scotland Eva Álvarez Andrés, MD Department of Rheumatology, Paediatric Rheumatology Unit, Hospital Universitario Severo Ochoa, Madrid, Spain Marina Backhaus, MD Department of Internal Medicine, Rheumatology and Clinical Immunology, Park-Klinik Weissensee Berlin, Academic Teaching Hospital of Charité, Berlin, Germany Anna Ciechomska, MD, PhD Department of Rheumatology, Wishaw General Hospital, Wishaw, UK Paz Collado Ramos, MD, PhD Department of Rheumatology, Paediatric Rheumatology Unit, Hospital Universitario Severo Ochoa, Madrid, Spain Zbigniew Czyrny, MD Private Practice, Diagnostic Imaging, Warsaw, Poland Hatem El-Azizi, MD Department of Radiodiagnosis, Cairo University Hospitals, Cairo, Egypt Yasser El Miedany, MD, FRCP Department of Rheumatology, Darent Valley Hospital, Dartford, UK Rheumatology and Rehabilitation Department, Ain Shams University, Cairo, Egypt Daniela Fodor, MD, PhD Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania John P. Harvie, MD Department of Rheumatology, Raigmore Hospital, Inverness, Scotland Cristina Hernández-Díaz, MD, MS Laboratorio de Ultrasonido Musculoesquelético y Articular, Instituto Nacional de Rehabilitación, Mexico City, Mexico Annamaria Iagnocco, MD Ultrasound Unit, Department of Rheumatology, Sapienza Università di Roma, Rome, Italy xiii

11 xiv Contributors Vasilia Iorgoveanu, MD Department of Internal Medicine and Rheumatology, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania Iustina Janţă, MD Department of Rheumatology, Hospital General Universitario Gregorio Marañon, Madrid, Spain Carolina Botar Jid, MD, PhD Department of Radiology, Emergency Clinical County Hospital Cluj, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania Adham Aboul Fotouh Khalil, MD, MSc New Kasr El Aini Teaching Hospital, Cairo University, Cairo, Egypt Mihaela C. Micu, MD Department of Rehabilitation II, Rheumatology Division, Rehabilitation Clinical Hospital Cluj-Napoca, Cluj-Napoca, Romania María Montoro, MD Department of Rheumatology, Hospital General Universitario Gregorio Marañon, Madrid, Spain Esperanza Naredo, MD Department of Rheumatology, Hospital General Universitario Gregorio Marañon, Madrid, Spain Rodina Nestorova, MD Department of Musculoskeletal Ultrasound, Rheumatology Centre St. Irina, Sofia, Bulgaria Margarida Alexandre Oliveira, MD Department of Rheumatology, Centro Hospitalar Cova da Beira, Covilhã, Portugal Violeta Maria Vlad, MD, PhD Department of Rheumatology, Sf. Maria Hospital, Bucharest, Romania Ximena Wortsman, MD Departments of Radiology and Dermatology, IDIEP- Institute for Diagnostic and Reasearch of the Skin and Soft Tissue, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile