Arthritis, Ultrasound And Diagnosis

Imagine yourself experiencing the worst pain imaginable. Now imagine that you are told that the most common diagnostic tools available cannot be used on you because to do so would be dangerous for you. Many arthritis patients have found themselves in this very situation, but fortunately, they had another option for diagnosis: ultrasound.

Many patients who are diagnosed with heart arrhythmia receive implanted pacemakers, and then go on with their lives. These days it is a fairly common and routine procedure. Patients who have implanted pacemakers often develop shooting pains in their joints, often debilitating joint pain. If their physician suspects a form of arthritis, the next step would typically be to confirm the diagnosis with a traditional MRI. But for a patient with an implanted pacemaker, this is not possible. Not only would the intense magnetism of the MRI fry the delicate electronics, it might cause the device to become dislodged. Any movement of the precisely placed pacemaker would render it ineffective, perhaps painfully so.

Though ultrasound machines have been mostly associated in recent years with obstetrics, rheumatologists are finding new uses for this well established technology. In addition to its clinical efficacy, ultrasound may also be a cheaper and safer tool for viewing soft tissues instantly.

The ultrasound machine can not only be used to help in the diagnostic process, but also with the delivery of drugs. Ultrasounds can help to guide needles right to the inflamed spot in a joint, maximizing the drugs’ effectiveness.

Before the use of ultrasound machines, doctors would have an initial MRI, but after that, they relied on patient reports to find out if they hurt more or if they felt the medicine was working. However, recent studies comparing ultrasound and MRI to routine clinical assessments (without imaging) have shown that, while up to a fifth of all rheumatoid arthritis patients felt they were in remission, they were, in fact continuing to experience joint-damaging inflammation–inflammation that was only detectable by imaging.

Now, with ultrasound testing, doctors can watch in real-time the progression of inflammation as blood gathers around a joint – just like a TV weatherman sees a radar picture of a storm system.

And the savings are not to be ignored, either. An MRI has an average cost of around twelve hundred dollars. It is too cost prohibitive to use to track the progression of the disease. But the in office ultrasound has a cost of about $120 per use or less. Add to that the readily accessible nature of the technology, and you have a new way to approach the prevalent problem of rheumatoid arthritis.