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Abstract(s)
O diagnóstico precoce das Espondilartrites (SpA) mantem-se ainda um desafio, devido à baixa especificidade e oscilação das manifestações clínicas, nestas patologias. Por este motivo, as técnicas de imagem têm um papel muito relevante na avaliação clínica e no diagnóstico destas doenças.
Ecógrafos de alta gama e com boa acuidade diagnóstica fornecem aos reumatologistas a informação necessária para a identificação da inflamação e danos estruturais precoces, permitem o acompanhamento e gestão diária da doença e permitem monitorizar a resposta às terapêuticas.
A aplicabilidade da ecografia a várias articulações e a possibilidade da avaliação dinâmica das estruturas articulares e peri-articulares, contribuíram para considerar esta técnica como um prolongamento natural do exame físico.
Vários estudos usaram a ecografia como técnica de imagem capaz de diferenciar entre SpA e outras patologias reumáticas, de acordo com o padrão de envolvimento articular. No entanto, sinais ecográficos isolados de sinovite e erosões nas SpA, não diferem daqueles que são observados noutros distúrbios inflamatórios reumatológicos.
A principal característica ecográfica específica e presente em todos os subtipos de SpA, parece ser a presença de entesites, caracteriza-se pelos achados ecograficos em escala de cinzentos: ecogenicidade, espessura, depósitos calcificados, entesofitos, rutura, erosões, irregularidades corticais e bursite.
Com esta revisão bibliográfica pretendemos reunir e rever a informação existente sobre a utilidade da ecografia no diagnóstico da Espondilite anquilosante e Artrite psoriática.
As palavras-chave “spondylitis, ankylosing” , “arthritis, psoriatic”, “musculoskeletal ultrasonography”, “power doppler sonography” e “classification criteria” foram utilizadas para a pesquisa de artigos científicos nas bases de dados PubMed e uptodate. Foi também realizada a leitura livros de texto onde este tema era abordado.
Early diagnosis of Spondylarthritis (SpA) is still a challenge, due to the low specificity and variations of clinical manifestations, in these pathologies. For this reason, imaging techniques have a very important role in the clinical evaluation and diagnosis of these diseases. High range ultrasound equipments with good diagnostic accuracy provide rheumatologists the necessary information for early identification of inflammation and structural damage, allow the management and daily monitoring of the disease and can monitor the response to therapies. The applicability of ultrasound to several joints and the possibility of dynamic evaluation of articular and peri-articular structures, contributed to consider this thecnique as a natural extension of the physical examination. Several studies have used ultrasound as an imaging technique that can differentiate between SpA and other rheumatic conditions, according to the pattern of joint involvement. However, isolated echographic signs of synovitis and erosions in SpA do not differ from those seen in other inflammatory rheumatic disorders. The main specific feature seen in all subtypes of SpA, seems to be the presence of enthesitis,characterized by ultrasound findings greyscale: echogenicity, thickness, calcific deposits, enthesophytes, tear, erosions, cortical irregularities and bursitis. With this literature review we intend to gather and review existing information about the utility of ultrasound in the diagnosis of ankylosing spondylitis and psoriatic arthritis. The keywords "spondylitis, ankylosing," "arthritis, psoriatic", "musculoskeletal ultrasonography", "power doppler sonography" and "classification criteria" were used for research papers in PubMed databases and uptodate. It was also held reading textbooks where this issue was addressed.
Early diagnosis of Spondylarthritis (SpA) is still a challenge, due to the low specificity and variations of clinical manifestations, in these pathologies. For this reason, imaging techniques have a very important role in the clinical evaluation and diagnosis of these diseases. High range ultrasound equipments with good diagnostic accuracy provide rheumatologists the necessary information for early identification of inflammation and structural damage, allow the management and daily monitoring of the disease and can monitor the response to therapies. The applicability of ultrasound to several joints and the possibility of dynamic evaluation of articular and peri-articular structures, contributed to consider this thecnique as a natural extension of the physical examination. Several studies have used ultrasound as an imaging technique that can differentiate between SpA and other rheumatic conditions, according to the pattern of joint involvement. However, isolated echographic signs of synovitis and erosions in SpA do not differ from those seen in other inflammatory rheumatic disorders. The main specific feature seen in all subtypes of SpA, seems to be the presence of enthesitis,characterized by ultrasound findings greyscale: echogenicity, thickness, calcific deposits, enthesophytes, tear, erosions, cortical irregularities and bursitis. With this literature review we intend to gather and review existing information about the utility of ultrasound in the diagnosis of ankylosing spondylitis and psoriatic arthritis. The keywords "spondylitis, ankylosing," "arthritis, psoriatic", "musculoskeletal ultrasonography", "power doppler sonography" and "classification criteria" were used for research papers in PubMed databases and uptodate. It was also held reading textbooks where this issue was addressed.
Description
Keywords
Artrite Psoriática Ecografia Entesite Espondilartrite Espondilite Anquilosante Power Doppler