Bálint, Péter Vince
Ultrasound imaging in joint and soft tissue inflammation.
PhD thesis, University of Glasgow.
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The use of ultrasound as an extended and more objective investigation performed as an extension of physical examination has a potential role in studying inflammation in different rheumatic diseases such as rheumatoid arthritis (RT) and spondylarthropathy (SpA). Rheumatoid arthritis is a chronic disease causing joint inflammation and destruction. Metacarpophalangeal (MCP) joint involvement is one of the earliest and most permanent signs of RA. US has been used to detect synovitis and erosions in MCP joints with high accuracy when compared to X-ray and magnetic resonance imaging (MRI). In RA joints, power Doppler has been used to detect increased blood flow as a potential sign of inflammation but grey-scale and power Doppler ultrasonography was not compared to another method to detect increased blood flow in MCP joints. After RA the next most common inflammatory group of diseases are the seronegative spondylarthropathies. In SpA joint inflammation and ankylosis occur in addition to periarticular enthesitis, which is one of the major hallmarks of the disease and has been poorly studied by ultrasonography.
In order to reduce observer variation in musculoskeletal ultrasound examination to the level of other imaging methods it is necessary to avoid direct contact between the observer and the subject. This problem has been addressed in the aerospace industry and led to the development of air-coupled non-destructive testing. Air-coupled ultrasonography has the potential in medial imaging to exclude observer variation if it is able to depict human anatomy. There are currently no data regarding airborne ultrasound in the musculoskeletal ultrasound literature.
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