Joint sonography in rheumatology

Sonographic examination of joints has become a decisive component in rheumatological diagnostics and is now indispensible in the clinical routine. The exceptional representation of acute inflammatory soft tissue processes, very early recognition of bony destruction and the ubiquitous availability of the method have been major contributors to this success. In recent years there have been new developments in technology and in examination methods. The substantial importance of sonography for early detection of arthritis, differential diagnostics, therapy monitoring and estimation of prognosis is underlined by the continuously increasing number of international publications. Several scoring systems have been developed for small and large joints and have been proven not only under study conditions but also in practice. Subclinical inflammatory processes which are held responsible for the so-called silent progression can be detected using sonography.