Use of Ultrasound in the Diagnosis and Management of the Vasculitides

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Current rheumatology reports


Purpose of review: The aim of this review paper is to evaluate the current data regarding clinical use of ultrasound (US) for diagnosis of systemic vasculitis. Recent findings: In recent years, US has emerged as an image modality taking a central role in the diagnosis and monitoring of vasculitides by measuring vessel wall inflammation and changes in vessel wall thickness. US has been recognized as an important tool predominantly in the diagnosis of large vessel vasculitis (LVV). Signs like the "halo sign" in temporal arteries of patients with giant cell arteritis (GCA) have demonstrated to be a robust marker. In other types of vasculitides the role of US is not well defined yet but could be of help by diagnosing secondary findings when there is organ involvement, like interstitial lung disease in small vessel vasculitis (SVV). Different modes of ultrasound (US) are being studied for this purpose, especially since it is a non-invasive technique that can limit exposure to ionizing radiation. In conclusion there is clear evidence for the use of US particularly color duplex US (CDS) in the diagnosis of LVV like GCA and Takayasu's arteritis (TAK). Nevertheless, there is urgent need for more data in regard to the use of US in small/medium vessel vasculitis, as well as the role of US in monitoring of patients with LVV.

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