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Ultrasound is an increasingly popular tool for evaluating muscle inflammation. It is a cost-effective alternative to MRI and can be used to diagnose and follow up on inflammatory myopathies, such as dermatomyositis and inclusion body myositis. Ultrasound can also be used to evaluate neuromuscular disorders, such as idiopathic inflammatory myopathies (IIM), and connective tissue diseases, such as deep morphea, or morphea profunda.
| Characteristics | Values |
|---|---|
| Use | Evaluation of muscle disorders, particularly inflammatory myopathies |
| Advantages | Cost-effective, easily applicable in multiple clinical settings, no contraindications |
| Disadvantages | Dependent on examiner expertise, assessment of muscle quality can be affected by machine/system settings |
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What You'll Learn
- Ultrasound as a cost-effective alternative to MRI
- Ultrasound's use in diagnosing dermatomyositis and inclusion body myositis
- Ultrasound's use in diagnosing deep morphea, or morphea profunda
- Ultrasound's use in diagnosing systemic lupus erythematosus
- Ultrasound's use in evaluating neuromuscular disorders
Ultrasound as a cost-effective alternative to MRI
Ultrasound is an upcoming tool in the evaluation of neuromuscular disorders. It is easily applicable in multiple clinical settings, has no contraindications, and provides a cost-effective alternative to other imaging modalities such as MRI. Ultrasound is also more widely available to patients in more places throughout the country as it does not require the same expensive and large machinery as MRI.
Ultrasound can be used as primary imaging to locate the source of a problem, and MRI can be used to follow up on abnormal findings and get a more detailed view if necessary. Ultrasound also allows dynamic scanning with direct interaction between the operator and the patient, as well as allowing guided intervention to be performed at the same time.
However, a known disadvantage of ultrasound is its dependence on examiner expertise. Furthermore, the assessment of muscle quality is done mainly through an assessment of muscle echo intensity, which is affected by machine/system settings, hampering comparison across centres.
Ultrasound has been shown to be useful for the diagnosis and follow-up of IIM, particularly for dermatomyositis and inclusion body myositis. It can also be used as a diagnostic and follow-up tool in patients with deep morphea, or morphea profunda. In cases of myositis, muscle US will show hyperechogenicity and atrophy.
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Ultrasound's use in diagnosing dermatomyositis and inclusion body myositis
Ultrasound is an upcoming tool in the evaluation of neuromuscular disorders, including dermatomyositis and inclusion body myositis. It is easily applicable in multiple clinical settings, has no contraindications, and provides a cost-effective alternative to other imaging modalities such as MRI.
Ultrasound can be used to show muscle inflammation. In myopathies, pathologic muscle shows an increase in echogenicity. Ultrasound of the skin and subdermis in areas with sclerotic plaques can show either inflammation with thickening or atrophy with thinning of the subcutaneous tissue layers, while muscle ultrasound will show hyperechogenicity and atrophy in cases with myositis.
Ultrasound has been used as a diagnostic and follow-up tool in patients with deep morphea, or morphea profunda. Studies have shown that ultrasound can be useful both for diagnosis and follow-up of IIM, particularly for dermatomyositis and inclusion body myositis.
However, a known disadvantage of ultrasound is its dependence on examiner expertise. Furthermore, the assessment of muscle quality is done mainly through an assessment of muscle echo intensity, which is affected by machine/system settings, hampering comparison across centres.
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Ultrasound's use in diagnosing deep morphea, or morphea profunda
Ultrasound is a cost-effective alternative to MRI and can be used to diagnose muscle inflammation. Studies have shown that ultrasound can be useful for the diagnosis and follow-up of IIM, particularly for dermatomyositis and inclusion body myositis.
Ultrasound has also been used as a diagnostic and follow-up tool in patients with deep morphea, or morphea profunda. Ultrasound of the skin and subdermis in areas with sclerotic plaques can show inflammation with thickening or atrophy with thinning of the subcutaneous tissue layers. In addition, ultrasound can be used to evaluate the stiffness of the subcutis, fascia and muscle.
Ultrasound imaging is a non-invasive and objective method for evaluating morphea. The combination of ultrasound and Doppler imaging allows for the evaluation of both superficial and deep soft tissue thicknesses, echogenicity, and subcutaneous vascularity of skin lesions in LoS. By using high-frequency ultrasound, quantitative assessments with higher resolutions can be performed.
Ultrasound has been used to diagnose morphea profunda, a rare subtype of localized scleroderma. It is difficult to evaluate the conditions of sclerotic changes at an early stage, but ultrasound can be used to find unexpected hyperechogenicity in the dermis and deeper tissue.
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Ultrasound's use in diagnosing systemic lupus erythematosus
Ultrasound can be used to evaluate joint pain in patients with systemic lupus erythematosus. It can also be used to identify patients with musculoskeletal symptoms who respond best to therapy.
Ultrasound can be used to assess musculoskeletal symptoms of systemic lupus erythematosus, and can be used to predict musculoskeletal flares and Jaccoud's arthropathy in patients with the condition.
One study compared the role of hand and wrist ultrasound in the diagnosis of subclinical synovitis in patients with systemic lupus erythematosus and rheumatoid arthritis.
Another study looked at the use of ultrasound in evaluating joint pain in systemic lupus erythematosus, and how this could be used to inform treatment.
An echocardiogram is an ultrasound test that uses sound waves to create images of the heart. This can be used to evaluate how well a patient's heart is functioning.
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Ultrasound's use in evaluating neuromuscular disorders
Ultrasound is an upcoming tool in the evaluation of neuromuscular disorders. It is easily applicable in multiple clinical settings, has no contraindications, and provides a cost-effective alternative to other imaging modalities such as MRI. Ultrasound can be useful for the diagnosis and follow-up of IIM, particularly for dermatomyositis and inclusion body myositis. In myopathies, pathologic muscle shows an increase in echogenicity. In cases of myositis, muscle ultrasound will show hyperechogenicity and atrophy.
Ultrasound of the skin and subdermis in areas with sclerotic plaques can show either inflammation with thickening or atrophy with thinning of the subcutaneous tissue layers. In systemic lupus erythematosus, a study has been done to evaluate muscle changes in patients without a clinical diagnosis of myositis. They found an increase in muscle thickness, pennation angle, and fascicle length in the vastus lateralis of lupus patients in comparison with controls.
A known disadvantage of ultrasound is its dependence on examiner expertise. Furthermore, the assessment of muscle quality is done mainly through an assessment of muscle echo intensity, which is affected by machine/system settings, hampering comparison across centres. Over the years, new methods have been developed to make results more objective and comparable for the assessment of myopathies.
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Frequently asked questions
Yes, ultrasound is a cost-effective alternative to MRI and can be used to show muscle inflammation.
Ultrasound is dependent on examiner expertise and muscle quality assessment is done through an assessment of muscle echo intensity, which is affected by machine/system settings.
Ultrasound is easily applicable in multiple clinical settings, has no contraindications, and is a cost-effective alternative to other imaging modalities such as MRI.
Yes, ultrasound can be used to diagnose and follow up on muscle inflammation, particularly for dermatomyositis and inclusion body myositis.
