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For many years, ultrasonography (US) has been a widely accepted modality used for joint assessment in patients with rheumatoid arthritis (RA). Given the efficacy of present day therapies, there is scepticism whether it is required in the first place. The most recent clinical Targeting synovitis in Early Rheumatoid Arthritis (TaSER) and Clinical Tight Control Therapy (ARCTIC) trials' results appear to contradict it, yet this does not necessarily mean ultrasound has no place in modern rheumatology. The possibility of detecting inflammation at a subclinical level carries a tremendous predictive value, enabling identification of patients likely to experience an exacerbation in the coming months. Therefore, US should be a part of the decision-making process regarding treatment modification or introduction of any additional interventions, such as glucocorticosteroid injections. The results of the most recent clinical trials do not negate the usefulness of US, but merely suggest that it ought to be used in moderation., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2020 Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie.)

Objective: Rheumatoid arthritis (RA) is a condition that poses many diagnostic problems. As a result, it is often diagnosed too late, which makes effective treatment more difficult. The course of the disease is chronic, and it causes irreversible changes in the musculoskeletal system, as well as bone destruction, and this in turn impairs the proper monitoring of the treatment. Therefore, in order to assess the treatment's efficacy, as well as a clinical examination of the patient and laboratory tests, diagnostic imaging is being used more frequently in routine practice. The aim of this paper is to assess the usefulness of power Doppler ultrasonography in the assessment of MCP joints in patients with chronic RA (LSRA), in comparison with DAS28, X-ray, and MRI., Material and Methods: The study involved 26 patients with LSRA, treated with biologics. It lasted for a year. At the moment of enrolment, the condition had lasted for a minimum of 5 years, and DAS28 was > 5.1. The patients had visits every three months. During every visit, a PDUS test was performed and the DAS28 was determined. In the first and last month of the study the patients underwent X-ray and MRI tests., Results: At the end of the study, the DAS28 of 26 (100%) patients was lower or equal to 3.2. Based on PDUS and MRI tests, no synovitis was found in 21 (81%) and 18 (69%) patients, respectively. According to the MRI results, radiological changes progressed in 5 (19%) of them. All patients who showed progress of radiological changes also had visible synovitis during their PDUS test., Conclusions: PDUS in patients with LSRA can be helpful in selecting patients, who are likely to develop a progression of radiological changes., Competing Interests: The authors declare no conflict of interest.

Rheumatoid arthritis (RA) is a chronic systemic connective tissue disease. The development of comorbidities often occurs in the course of RA. One of them is osteoporosis, which has serious social and economic effects and may contribute to the increase in the degree of disability and premature death of the patient. Due to the young age in which RA disease occurs, densitometry (DXA) of the lumbar spine is the basic examination in osteoporosis diagnostics. In the course of RA, much more frequently than in healthy persons of the same age, osteoporotic fractures of vertebral bodies occur, which hinder a correct assessment in the DXA test. Rheumatoid arthritis patients often undergo computed tomography (CT) examination of the abdominal cavity for other medical indications than suspected spinal injury. Then, CT examination may also serve for the assessment of bone density, especially in patients with osteoporotic fractures.

Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are chronic progressive inflammatory diseases, leading to joint damage and reducing the physical fitness of patients. They are among the most common rheumatic diseases. However, their etiology and symptomatology are different. Formerly, AS was often wrongly diagnosed as RA. Today there are no major diagnostic difficulties in differentiation between these diseases, thanks to modern laboratory tests and imaging. However, a problem may arise when the patient has symptoms typical for both diseases simultaneously. Cases of coexistence of RA with AS - according to our best knowledge - are rare. This study aims to compare our experience in diagnosis and treatment of concomitant RA and AS with the experience of other researchers. Implementation of the proper diagnostic algorithm, allowing for correct diagnosis of both diseases in one patient, may be useful for differential diagnosis of similar cases in the future.

Rheumatoid arthritis (RA) is a chronic systemic connective tissue disease which is characterized by symetrical multiple joints involvement and extra-articular symptoms. Current EULAR diagnostic criteria for RA include disease activity parameters, such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), which are used to calculate disease activity scores, including DAS and DAS28. Recently attempts have been made to assess disease activity using imaging diagnostic modalities, such as magnetic resonance imaging (MRI) and ultrasonography (US). Due to significant progress in therapy effectiveness and early RA diagnosis possibility, imaging modalities become increasingly meaningful and many clinical trials confirm their usefulness. However, there are no consistent criteria for objective assessment of therapy effectiveness based on US. Moreover, it is not US availability that limits its common use, but rather significant variability between operators. This is why US remains only an additional tool to assess therapy efficacy with regard to DAS/DAS28 index.