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Abstract: Article presents a review of the scientific literature containing data on the role of ultrasound examination of joints in the diagnosis of rheumatoid arthritis, ultrasound signs of damage of main elements of joints and periarticular tissues, modern semi-quantitative scales for assessing the severity of main pathological changes detected by ultrasound examination of joints and tendons in patients with rheumatoid arthritis. Aim: was to analyze scientific publications in domestic and world literature on ultrasound examination of joints in rheumatoid arthritis. Materials and methods: 38 scientific sources of leading domestic and foreign journals were analyzed. Results: currently, radiography is the gold standard in the diagnosis of rheumatoid arthritis and is widely used to monitor the progression of rheumatoid arthritis. However, it is not sensitive enough to detect changes at early stage of rheumatoid arthritis, since it only allows assessing bone structures that are involved in the pathological process 6-12 months after the onset of first signs of the disease. Ultrasound examination provides new possibilities for early detection of rheumatoid arthritis, since it allows to detect changes at early pre-radiological stage and to prevent the development of significant structural changes leading to early disability of patients. Conclusion: the use of ultrasound examination of joints in the diagnosis of rheumatoid arthritis accelerates the diagnosis, is used to dynamically assess the course of the disease, evaluate the effectiveness of therapy, and also to predict outcomes. The diagnostic effectiveness of ultrasound examination of joints in rheumatoid arthritis involves the identification of synovitis, tenosynovitis, structural changes in the articular cartilage and bone (erosion), and an assessment of the severity of the inflammatory reaction.
Abstract: Introduction: article provides a literature review on the role of various imaging methods used in the diagnosis and control of effectiveness of therapy for rheumatoid arthritis. Aim: to analyze domestic and foreign literature sources reflecting the state of the problem and aspects of radiological diagnosis of rheumatoid arthritis. Materials and methods: 52 scientific sources of leading domestic and foreign journals were analyzed. Results: conventional radiography today is the most widely used imaging technique for diagnosing and monitoring of progression of rheumatoid arthritis. However, it is not sensitive enough to detect changes in the early stage of rheumatoid arthritis, since it only allows assessment of bone structures. Establishing the diagnosis of rheumatoid arthritis at the stage of detecting structural abnormalities in joints indicates the presence of functional impairment and disability of patients. At the same time, early diagnosis of rheumatoid arthritis, at the stage of pre-radiological changes, leads to an improved prognosis of the disease and contributes to preservation of working capacity. In this regard, it becomes necessary to introduce into clinical practice sensitive advanced imaging methods aimed at identifying changes that precede the development of structural changes in bone. Conclusion: the diagnostic effectiveness of radiation research methods in rheumatoid arthritis implies the identification of synovitis, tenosynovitis, early inflammatory changes in the bone, structural changes in the articular cartilage and bone (erosion), assessment of the severity of the inflammatory response. References 1. Muravyev YuV. Extraarticular manifestations of rheumatoid arthritis. Nauchno-prakticheskaya revmatologiya. 2018; 56(3): 356-362 [In Russ]. https://doi.org/10.14412/1995-4484-2018-356-362 2. Nasonov EL, Olyunin YuA, Lila AM. 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Abstract: Introduction: the diagnosis of osteomyelitis in children and adolescents in early stages is the key to successful treatment of this formidable disease. Timely treatment will avoid a deterioration in the quality of life of patients, which is extremely important for adolescent patients. In recent decades, there has been an increase in the percentage of patients with osteomyelitis in childhood and adolescence. Non-specific clinical manifestations of the disease and the absence of manifestations on radiographs for a long time lead to an incorrect interpretation of clinical and radiological data. Aim: was to demonstrate possibilities of magnetic resonance imaging (MRI) and ultrasound (ultrasound) in diagnosis of osteomyelitis in case of adverse anatomical localization. Material and methods: we present a case report of complex radiation diagnosis of inflammatory lesions of the musculoskeletal system of adverse anatomical localization in a teenager. Clinically patient suffered from severe pain in left hip joint with pain radiation to the left thigh, limitation of movements in the joint concerned, swelling of soft tissues of the left thigh and gluteal region against the background of hyperthermia. Results: according to data of digital radiography, the patient did not reveal signs of the destructive process of bone tissue. Changes in the form of psoit and coxitis were detected by ultrasound. Examination was supplemented by MRI, according to which on T2 FatSat in coronal and axial projections the left-sided synovitis was confirmed, without inflammatory changes in the bone tissue. 10 days after, MRI revealed inflammatory changes in the bone marrow of the head of left femur, left pubic and iliac bones, adjacent soft tissues and left-sided synovitis, regarded as a manifestation of acute hematogenous osteomyelitis. Patient underwent surgical and symptomatic treatment with a positive result. Conclusions: 1. Absence of pathological changes according to x-ray examinations in children and adolescents (radiography and MSCT) does not exclude the presence of osteomyelitis, due to the absence of manifestations on radiographs for a long time. 2. At early stages of disease, especially in young children, as well as at stages of conservative and surgical treatment, the most appropriate use of ultrasound and MRI. 3. Conducting MSCT is advisable after obtaining ultrasound and MRI data on the presence of bonedestructive changes. References 1. Bruchanov AV, Vasiliev AYu. Magnetic resonance imaging in osteology. Publishing house «Medicine», 2006; 200. [In Russ]. 2. Trufanov GE, Fokin VA. Features of the application of radiation diagnostic methods in pediatric practice. Vestnik sovremennoj klinicheskoj mediciny.2013; 6(6): 48–52 [In Russ]. 3. Peltola H, Paakkonen M. Acute Osteomyelitis in Children. N Engl J Med 2014; 370: 352-360. 4. Basu S, Chryssikos T, Moghadem-Kia S, Zhuang H, Torigian DA, Alavi A. Positron emisson tomography as a diagnostic tool in infection: present role and future possibilities. Semin. Nucl. Med. 2009; 39 (1): 36-51 5. Vasiliev AYu, Olkhova EB. Fundamentals of ultrasound diagnostics in pediatrics and pediatric surgery. M. 2019: 171-190 [In Russ].
Abstract: A standard X-ray is still the most affordable method of evaluation of patients, including those with spinal diseases since 1895 when X-rays were found and were introduced into general practice. In the standard X-ray examination of the spine and all the anatomical structures located at different depths and different distances, projected onto x-ray film or a screen in the form of planar image. In order to neutralize these drawbacks and to improve visualization, various tomographic techniques have been developed. The most modern and promising diagnostic method is a multisection linear imaging (tomosynthesis), in which a single pass X-ray tube is a series of slices. Digital X-ray tomography with multislice linear are used as a rule, in the world, for examination of breast and lungs. The article presents data on the different types of X-ray tomography in evaluation of patients with tuberculous spondylitis.
