Vascular ultrasound in rheumatology practice

IF 4.5 2区医学 Q1 RHEUMATOLOGY

Best Practice & Research in Clinical Rheumatology Pub Date : 2023-03-01 DOI:10.1016/j.berh.2023.101847

Wolfgang A. Schmidt

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引用次数: 1

Abstract

Rheumatologists are increasingly using vascular ultrasound. Several guidelines now recommend ultrasound as the first diagnostic modality in giant cell arteritis (GCA). The German curriculum for rheumatology training has recently included ultrasound for the acute diagnosis of vasculitis.

Recent studies have shown that ultrasound of temporal, axillary, subclavian, and vertebral arteries has sensitivities and specificities of >90%.

Vascular ultrasound detects subclinical GCA in approximately 20% of patients with “pure” polymyalgia rheumatica. GCA fast-track clinics might regularly include these patients.

A new score based on the intima-media thickness of the temporal and axillary arteries allows the monitoring of structural changes with treatment. The score decreases faster for the temporal arteries than it does for the axillary arteries.

Measuring the diameter of the ascending aorta and the aortic arch might become a fast and cost-effective tool for the long-term monitoring of aortic aneurysms in extracranial GCA.

Vascular ultrasound also has a role for Takayasu arteritis, thrombosis, Behçet's syndrome, and Raynaud's phenomenon.

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风湿病学实践中的血管超声

风湿病学家越来越多地使用血管超声。目前，一些指南建议将超声波作为巨细胞动脉炎（GCA）的首选诊断方式。最近的研究表明，颞动脉、腋动脉、锁骨下动脉和椎动脉超声检查的敏感性和特异性均达到 90%。血管超声检查可发现约 20% 的 "单纯 "多发性风湿痛患者的亚临床 GCA。根据颞动脉和腋动脉内膜中层厚度得出的新评分可以监测治疗后的结构变化。测量升主动脉和主动脉弓的直径可能会成为长期监测颅外 GCA 主动脉瘤的一种快速、经济有效的工具。血管超声在高安动脉炎、血栓形成、白塞氏综合征和雷诺现象中也能发挥作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Best Practice & Research in Clinical Rheumatology 医学-风湿病学

CiteScore

9.40

自引率

0.00%

发文量

审稿时长

27 days

期刊介绍： Evidence-based updates of best clinical practice across the spectrum of musculoskeletal conditions. Best Practice & Research: Clinical Rheumatology keeps the clinician or trainee informed of the latest developments and current recommended practice in the rapidly advancing fields of musculoskeletal conditions and science. The series provides a continuous update of current clinical practice. It is a topical serial publication that covers the spectrum of musculoskeletal conditions in a 4-year cycle. Each topic-based issue contains around 200 pages of practical, evidence-based review articles, which integrate the results from the latest original research with current clinical practice and thinking to provide a continuous update. Each issue follows a problem-orientated approach that focuses on the key questions to be addressed, clearly defining what is known and not known. The review articles seek to address the clinical issues of diagnosis, treatment and patient management. Management is described in practical terms so that it can be applied to the individual patient. The serial is aimed at the physician in both practice and training.