Concepts in monitoring the treatment in rheumatoid arthritis - the role of musculoskeletal ultrasound. Part I: synovitis

Rheumatoid arthritis (RA) is an incurable chronic inflammatory disease associated with significant functional impairment and disability, linked to inflammatory and structural articular and peri-articular damage. Structural damage occurs rapidly in RA if inflammation is not efficiently suppressed. Identification of patients with high risk to develop RA followed by an early application of efficient medications and standard 'treat to target' recommendations allow a better management aiming remission. Over the last 15 years musculoskeletal ultrasound (MSUS) has proved to detect subclinical inflammatory lesions; thus, targeting therapy to imaging delivered information may provide superior outcomes and a more rapid response to therapy detection in comparison with clinical examination alone. This review provides an insight into the importance of MSUS in quantifying disease activity and monitoring of therapies in RA patients.