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Ultrasound imaging in rheumatoid arthritis

  • MUSCULOSKELETAL RADIOLOGY
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Abstract

Over the last decades, ultrasound (US) has undergone a dramatic evolution in the field of inflammatory joint diseases. Rheumatoid arthritis (RA) is probably the pathology that has most benefited from this development, both in terms of early diagnosis and monitoring of disease activity. The RA-induced morpho-structural changes can be effectively detected and measured by US, and US findings represent an additional advantage over clinical and laboratory evaluation, showing the face of the disease (i.e., proliferative synovitis) and revealing its aggressive behavior (i.e., presence of bone erosions not detectable by conventional radiography). The present review provides an overview of the main studies focusing on the value of US in the assessment of the patients with RA, and discussing the elementary lesions detectable by US (synovitis, bone erosion, cartilage damage, tenosynovitis and tendon damage), the scoring systems currently available and the scanning protocols in definite clinical settings (undifferentiated arthritis, early and long standing RA).

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References

  1. McInnes IB, O’Dell JR (2010) State-of-the-art: rheumatoid arthritis. Ann Rheum Dis 69:1898–1906. https://doi.org/10.1136/ard.2010.134684

    Article  CAS  PubMed  Google Scholar 

  2. Smolen JS, Van Der Heijde DM, St Clair EW et al (2006) Predictors of joint damage in patients with early rheumatoid arthritis treated with high-dose methotrexate with or without concomitant infliximab: results from the ASPIRE trial. Arthritis Rheum 54:702–710. https://doi.org/10.1002/art.21678

    Article  CAS  PubMed  Google Scholar 

  3. Naredo E, Collado P, Cruz A et al (2007) Longitudinal power Doppler ultrasonographic assessment of joint inflammatory activity in early rheumatoid arthritis: predictive value in disease activity and radiologic progression. Arthritis Rheum 57:116–124. https://doi.org/10.1002/art.22461

    Article  PubMed  Google Scholar 

  4. Dougados M, Devauchelle-Pensec V, Ferlet JF et al (2013) The ability of synovitis to predict structural damage in rheumatoid arthritis: a comparative study between clinical examination and ultrasound. Ann Rheum Dis 72:665–671. https://doi.org/10.1136/annrheumdis-2012-201469

    Article  PubMed  Google Scholar 

  5. Combe B, Landewe R, Daien CI et al (2017) 2016 Update of the EULAR recommendations for the management of early arthritis. Ann Rheum Dis 76:948–959. https://doi.org/10.1136/annrheumdis-2016-210602

    Article  PubMed  Google Scholar 

  6. Colebatch AN, Edwards CJ, Østergaard M et al (2013) EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis. Ann Rheum Dis 72:804–814. https://doi.org/10.1136/annrheumdis-2012-203158

    Article  PubMed  Google Scholar 

  7. D’Agostino MA, Terslev L, Wakefield R et al (2016) Novel algorithms for the pragmatic use of ultrasound in the management of patients with rheumatoid arthritis: from diagnosis to remission. Ann Rheum Dis 75:1902–1908. https://doi.org/10.1136/annrheumdis-2016-209646

    Article  PubMed  Google Scholar 

  8. Filippucci E, Di Geso L, Grassi W (2014) Progress in imaging in rheumatology. Nat Rev Rheumatol 10:628–634. https://doi.org/10.1038/nrrheum.2014.145

    Article  PubMed  Google Scholar 

  9. Sarzi-Puttini P, Filippucci E, Adami S et al (2018) Clinical, ultrasound, and predictability outcomes following certolizumab pegol treatment (with methotrexate) in patients with moderate-to-severe rheumatoid arthritis: 52-week results from the CZP-SPEED study. Adv Ther 35:1153–1168. https://doi.org/10.1007/s12325-018-0751-8

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. D’Agostino MA, Terslev L, Aegerter P et al (2017) Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce—part 1: definition and development of a standardised, consensus-based scoring system. RMD Open 3:e000428. https://doi.org/10.1136/rmdopen-2016-000428

    Article  PubMed  PubMed Central  Google Scholar 

  11. Filippucci E, Iagnocco A, Meenagh G et al (2007) Ultrasound imaging for the rheumatologist VII. Ultrasound imaging in rheumatoid arthritis. Clin Exp Rheumatol 25:5–10

    CAS  PubMed  Google Scholar 

  12. Grassi W, Okano T, Di Geso L, Filippucci E (2015) Imaging in rheumatoid arthritis: options, uses and optimization. Expert Rev Clin Immunol 11:1131–1146. https://doi.org/10.1586/1744666X.2015.1075395

    Article  CAS  PubMed  Google Scholar 

  13. Wakefield RJ, Balint PV, Szkudlarek M et al (2005) Musculoskeletal ultrasound including definitions for ultrasonographic pathology. J Rheum 32:2485–2487

    PubMed  Google Scholar 

  14. Filippucci E, da Luz KR, Di Geso L et al (2010) Interobserver reliability of ultrasonography in the assessment of cartilage damage in rheumatoid arthritis. Ann Rheum Dis 69:1845–1848. https://doi.org/10.1136/ard.2009.125179

    Article  PubMed  Google Scholar 

  15. Bruyn GA, Hanova P, Iagnocco A et al (2014) Ultrasound definition of tendon damage in patients with rheumatoid arthritis. Results of a OMERACT consensus-based ultrasound score focusing on the diagnostic reliability. Ann Rheum Dis 73:1929–1934. https://doi.org/10.1136/annrheumdis-2013-203596

    Article  PubMed  Google Scholar 

  16. Wakefield RJ, Gibbon WW, Conaghan PG et al (2000) The value of sonography in the detection of bone erosions in patients with rheumatoid arthritis: a comparative study with conventional radiography. Arthritis Rheum 43:2762–2770. https://doi.org/10.1002/1529-0131(200012)43:12%3c2762:AID-ANR16%3e3.0.CO;2-%23

    Article  CAS  PubMed  Google Scholar 

  17. Chiavaras MM, Jacobson JA, Yablon CM, Brigido MK, Girish G (2014) Pitfalls in wrist and hand ultrasound. Am J Roentgenol 203:531–540. https://doi.org/10.2214/AJR.14.12711

    Article  Google Scholar 

  18. Boutry N, Lardé A, Demondion X, Cortet B, Cotten H, Cotten A (2004) Metacarpophalangeal joints at US in asymptomatic volunteers and cadaveric specimens. Radiology 232:716–724. https://doi.org/10.1148/radiol.2323031075

    Article  PubMed  Google Scholar 

  19. Finzel S, Ohrndorf S, Englbrecht M et al (2011) A detailed comparative study of high-resolution ultrasound and micro-computed tomography for detection of arthritic bone erosions. Arthritis Rheum 63:1231–1236. https://doi.org/10.1002/art.30285

    Article  PubMed  Google Scholar 

  20. Schmidt WA, Schmidt H, Schicke B, Gromnica-Ihle E (2004) Standard reference values for musculoskeletal ultrasonography. Ann Rheum Dis 63:988–994. https://doi.org/10.1136/ard.2003.015081

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Tămaş MM, Filippucci E, Becciolini A et al (2014) Bone erosions in rheumatoid arthritis: ultrasound findings in the early stage of the disease. Rheumatology (Oxford) 53:1100–1107. https://doi.org/10.1093/rheumatology/ket484

    Article  Google Scholar 

  22. Mandl P, Supp G, Baksa G et al (2015) Relationship between radiographic joint space narrowing, sonographic cartilage thickness and anatomy in rheumatoid arthritis and control joints. Ann Rheum Dis 74:2022–2027. https://doi.org/10.1136/annrheumdis-2014-205585

    Article  CAS  PubMed  Google Scholar 

  23. Hurnakova J, Filippucci E, Cipolletta E et al (2019) Prevalence and distribution of cartilage damage at the metacarpal head level in rheumatoid arthritis and osteoarthritis: an ultrasound study. Rheumatology (Oxford). https://doi.org/10.1093/rheumatology/key443

    Article  Google Scholar 

  24. Torp-Pedersen S, Bartels EM, Wihjelm J, Biddal H (2011) Articular cartilage thickness measured with US is not easy as it appears: a systematic review of measurement techniques and image interpretation. Ultrashall Med 32:54–61. https://doi.org/10.1055/s-0029-1245386

    Article  CAS  Google Scholar 

  25. Filippucci E, Gabba A, Di Geso L, Girolimetti R, Salaffi F, Grassi W (2012) Hand tendon involvement in rheumatoid arthritis: an ultrasound study. Semin Arthritis Rheum 41:752–760. https://doi.org/10.1016/j.semarthrit.2011.09.006

    Article  PubMed  Google Scholar 

  26. Lillegraven S, Bøyesen P, Hammer HB et al (2011) Tenosynovitis of the extensor carpi ulnaris tendon predicts erosive progression in early rheumatoid arthritis. Ann Rheum Dis 70:2049–2050. https://doi.org/10.1136/ard.2011

    Article  PubMed  Google Scholar 

  27. Barn R, Turner DE, Rafferty D, Sturrock RD, Woodburn J (2013) Tibialis posterior tenosynovitis and associated pes plano valgus in rheumatoid arthritis: electromyography, multisegment foot kinematics, and ultrasound features. Arthritis Care Res (Hoboken) 65:495–502. https://doi.org/10.1002/acr.21859

    Article  Google Scholar 

  28. Downey DJ, Simkin PA, Mack LA, Richardson ML, Kilcoyne RF, Hansen ST (1988) Tibialis posterior tendon rupture: a cause of rheumatoid flat foot. Arthritis Rheum 31:441–446. https://doi.org/10.1002/art.1780310319

    Article  CAS  PubMed  Google Scholar 

  29. Scheel AK, Hermann KG, Kahler E et al (2005) A novel ultrasonographic synovitis scoring system suitable for analyzing finger joint inflammation in rheumatoid arthritis. Arthritis Rheum 52:733–743. https://doi.org/10.1002/art.20939

    Article  PubMed  Google Scholar 

  30. Szkudlarek M, Court-Payen M, Jacobsen S, Klarlund M, Thomsen HS, Ostergaard M (2003) Interobserver agreement in ultrasonography of the finger and toe joints in rheumatoid arthritis. Arthritis Rheum 48:955–962. https://doi.org/10.1002/art.10877

    Article  PubMed  Google Scholar 

  31. Brown AK, Quinn MA, Karim Z et al (2006) Presence of significant synovitis in rheumatoid arthritis patients with disease-modifying antirheumatic drug-induced clinical remission: evidence from an imaging study may explain structural progression. Arthritis Rheum 54:3761–3773. https://doi.org/10.1002/art.22190

    Article  CAS  PubMed  Google Scholar 

  32. Terslev L, Naredo E, Aegerter P et al (2017) Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce—Part 2: reliability and application to multiple joints of a standardised consensus-based scoring system. RMD Open 3:e000427. https://doi.org/10.1136/rmdopen-2016-000427

    Article  PubMed  PubMed Central  Google Scholar 

  33. Kane D, Grassi W, Sturrock R, Balint PV (2004) Musculoskeletal ultrasound-a state of the art review in rheumatology. Part 2: clinical indications for musculoskeletal ultrasound in rheumatology. Rheumatology (Oxford) 43:829–838. https://doi.org/10.1093/rheumatology/keh215

    Article  CAS  Google Scholar 

  34. Ohrndorf S, Messerschmidt J, Reiche BE, Burmester GR, Backhaus M (2014) Evaluation of a new erosion score by musculoskeletal ultrasound in patients with rheumatoid arthritis: Is US ready for a new erosion score? Clin Rheumatol 33:1255–1262. https://doi.org/10.1007/s10067-014-2646-7

    Article  CAS  PubMed  Google Scholar 

  35. Zayat AS, Ellegaard K, Conaghan PG et al (2015) The specificity of ultrasound-detected bone erosions for rheumatoid arthritis. Ann Rheum Dis 74:897–903. https://doi.org/10.1136/annrheumdis-2013-204864

    Article  PubMed  Google Scholar 

  36. Disler DG, Raymond E, May DA, Wayne JS, McCauley TR (2000) Articular cartilage defects: in vitro evaluation of accuracy and interobserver reliability for detection and grading with US. Radiology 215:846–851. https://doi.org/10.1148/radiology.215.3.r00jn20846

    Article  CAS  PubMed  Google Scholar 

  37. Mandl P, Filippucci E, Alasti F et al (2016) FRI0519 ultrasound definition of cartilage change in patients with rheumatoid arthritis: a reliability study by the omeract ultrasonography. Ann Rheum Dis 75:627. https://doi.org/10.1136/annrheumdis-2016-eular.3282

    Article  Google Scholar 

  38. Hammer HB, Kvien TK (2011) Ultrasonography shows significant improvement in wrist and ankle tenosynovitis in rheumatoid arthritis patients treated with adalimumab. Scand J Rheumatol 40:178–182. https://doi.org/10.3109/03009742.2010.517549

    Article  CAS  PubMed  Google Scholar 

  39. Di Geso L, Filippucci E, Meenagh G et al (2012) CS injection of tenosynovitis in patients with chronic inflammatory arthritis: the role of US. Rheumatology (Oxford) 51:1299–1303. https://doi.org/10.1093/rheumatology/kes027

    Article  Google Scholar 

  40. Naredo E, D’Agostino MA, Wakefield RJ et al (2013) Reliability of a consensus-based ultrasound score for tenosynovitis in rheumatoid arthritis. Ann Rheum Dis 72:1328–1334. https://doi.org/10.1136/annrheumdis-2012-202092

    Article  PubMed  Google Scholar 

  41. Backhaus M, Ohrndorf S, Kellner H et al (2009) Evaluation of a novel 7-joint ultrasound score in daily rheumatologic practice: a pilot project. Arthritis Rheum 61:1194–1201. https://doi.org/10.1002/art.24646

    Article  CAS  PubMed  Google Scholar 

  42. Brown AK, Conaghan PG, Karim Z et al (2008) An explanation for the apparent dissociation between clinical remission and continued structural deterioration in rheumatoid arthritis. Arthritis Rheum 58:2567–2958. https://doi.org/10.1002/art.23945

    Article  Google Scholar 

  43. Felson DT, Smolen JS, Wells G et al (2011) American College of Rheumatology/European League Against Rheumatism provisional definition of remission in rheumatoid arthritis for clinical trials. Ann Rheum Dis 70:404–413. https://doi.org/10.1136/ard.2011.149765

    Article  PubMed  Google Scholar 

  44. Naredo E, Gamero F, Bonilla G, Uson J, Carmona L, Laffon A (2005) Ultrasonographic assessment of inflammatory activity in rheumatoid arthritis: comparison of extended versus reduced joint evaluation. Clin Exp Rheumatol 23:881–884

    CAS  PubMed  Google Scholar 

  45. Salaffi F, Ciapetti A, Gasparini S, Carotti M, Filippucci E, Grassi W (2010) A clinical prediction rule combining routine assessment and power Doppler ultrasonography for predicting progression to rheumatoid arthritis from early-onset undifferentiated arthritis. Clin Exp Rheumatol 28:686–694

    CAS  PubMed  Google Scholar 

  46. Perricone C, Ceccarelli F, Modesti M et al (2012) The 6-joint ultrasonographic assessment: a valid, sensitive-to-change and feasible method for evaluating joint inflammation in RA. Rheumatology (Oxford) 51:866–873. https://doi.org/10.1093/rheumatology/ker405

    Article  Google Scholar 

  47. Damjanov N, Radunovic G, Prodanovic S et al (2012) Construct validity and reliability of ultrasound disease activity score in assessing joint inflammation in RA: comparison with DAS-28. Rheumatology (Oxford) 51:120–128. https://doi.org/10.1093/rheumatology/ker255

    Article  Google Scholar 

  48. Zufferey P, Tamborrini G, Gabay C et al (2013) Recommendations for the use of ultrasound in rheumatoid arthritis: literature review and SONAR score experience. Swiss Med Wkly 143:w13861. https://doi.org/10.4414/smw.2013.13861

    Article  PubMed  Google Scholar 

  49. Yoshimi R, Ihata A, Kunishita Y et al (2014) A novel 8-joint ultrasound score is useful in daily practice for rheumatoid arthritis. Mod Rheumatol 25:379–385. https://doi.org/10.3109/14397595.2014.974305

    Article  PubMed  Google Scholar 

  50. D’Agostino MA, Boers M, Wakefield RJ et al (2016) Exploring a new ultrasound score as a clinical predictive tool in patients with rheumatoid arthritis starting abatacept: results from the APPRAISE study. RMD Open 2:e000237. https://doi.org/10.1136/rmdopen-2015-000237

    Article  PubMed  PubMed Central  Google Scholar 

  51. Salaffi F, Di Carlo M, Iannone F et al (2018) the ultrasound-clinical arthritis activity (US-CLARA) index: properties of a new composite disease activity index for rheumatoid arthritis. Semin Arthritis Rheum 47:619–629. https://doi.org/10.1016/j.semarthrit.2017.09.013

    Article  PubMed  Google Scholar 

  52. Sconfienza LM, Albano D, Allen G et al (2018) Clinical indications for musculoskeletal ultrasound updated in 2017 by European Society of Musculoskeletal Radiology (ESSR) consensus. Eur Radiol 28:5338–5351. https://doi.org/10.1007/s00330-018-5474-3

    Article  PubMed  Google Scholar 

  53. Möller I, Janta I, Backhaus M et al (2017) The 2017 EULAR standardised procedures for ultrasound imaging in rheumatology. Ann Rheum Dis 76:1974–1979. https://doi.org/10.1136/annrheumdis-2017-211585

    Article  PubMed  Google Scholar 

  54. Freeston JE, Wakefield RJ, Conaghan PG, Hensor EM, Stewart SP, Emery P (2010) A diagnostic algorithm for persistence of very early inflammatory arthritis: the utility of power Doppler ultrasound when added to conventional assessment tools. Ann Rheum Dis 69:417–419. https://doi.org/10.1136/ard.2008.106658

    Article  CAS  PubMed  Google Scholar 

  55. Nam JL, Hensor EM, Hunt L, Conaghan PG, Wakefield RJ, Emery P (2016) Ultrasound findings predict progression to inflammatory arthritis in anti-CCP antibody-positive patients without clinical synovitis. Ann Rheum Dis 75:2060–2067. https://doi.org/10.1136/annrheumdis-2015-208235

    Article  PubMed  Google Scholar 

  56. Kawashiri SY, Suzuki T, Okada A et al (2013) Musculoskeletal ultrasonography assists the diagnostic performance of the 2010 classification criteria for rheumatoid arthritis. Mod Rheumatol 23:36–43. https://doi.org/10.1007/s10165-012-0628-7

    Article  PubMed  Google Scholar 

  57. Ji L, Deng X, Geng Y, Song Z, Zhang Z (2017) The additional benefit of ultrasonography to 2010 ACR/EULAR classification criteria when diagnosing rheumatoid arthritis in the absence of anti-cyclic citrullinated peptide antibodies. Clin Rheumatol 36:261–267. https://doi.org/10.1007/s10067-016-3465-9

    Article  PubMed  Google Scholar 

  58. Millot F, Clavel G, Etchepare F et al (2011) Musculoskeletal ultrasonography in healthy subjects and ultrasound criteria for early arthritis (the ESPOIR cohort). J Rheumatol 38:613–620. https://doi.org/10.3899/jrheum.100379

    Article  PubMed  Google Scholar 

  59. Nakagomi D, Ikeda K, Okubo A et al (2013) Ultrasound can improve the accuracy of the 2010 American College of Rheumatology/European League against rheumatism classification criteria for rheumatoid arthritis to predict the requirement for methotrexate treatment. Arthritis Rheum 65:890–898. https://doi.org/10.1002/art.37848

    Article  CAS  PubMed  Google Scholar 

  60. van der Ven M, van der Veer-Meerkerk M, Ten Cate DF et al (2017) Absence of ultrasound inflammation in patients presenting with arthralgia rules out the development of arthritis. Arthritis Res Ther 19:202. https://doi.org/10.1186/s13075-017-1405-y

    Article  PubMed  PubMed Central  Google Scholar 

  61. Filer A, de Pablo P, Allen G et al (2011) Utility of ultrasound joint counts in the prediction of rheumatoid arthritis in patients with very early synovitis. Ann Rheum Dis 70:500–507. https://doi.org/10.1136/ard.2010.131573

    Article  PubMed  Google Scholar 

  62. Grassi W, Gaywood I, Pande I, Filippucci E (2012) From DAS 28 to SAS 1. Clin Exp Rheumatol 30:649–651

    PubMed  Google Scholar 

  63. Schmidt WA (2001) Value of sonography in diagnosis of rheumatoid arthritis. Lancet 357:1056–1057. https://doi.org/10.1016/S0140-6736(00)04304-X

    Article  CAS  PubMed  Google Scholar 

  64. Szkudlarek M, Terslev L, Wakefield RJ et al (2016) Summary findings of a systematic literature review of the ultrasound assessment of bone erosions in rheumatoid arthritis. J Rheumatol 43:12–21. https://doi.org/10.3899/jrheum.141416

    Article  PubMed  Google Scholar 

  65. Baillet A, Gaujoux-Viala C, Mouterde G et al (2011) Comparison of the efficacy of sonography, magnetic resonance imaging and conventional radiography for the detection of bone erosions in rheumatoid arthritis patients: a systematic review and meta-analysis. Rheumatology (Oxford) 50:1137–1147. https://doi.org/10.1093/rheumatology/keq437

    Article  Google Scholar 

  66. Janta I, Valor L, De la Torre I et al (2016) Ultrasound-detected activity in rheumatoid arthritis on methotrexate therapy: Which joints and tendons should be assessed to predict unstable remission? Rheumatol Int 36:387–396. https://doi.org/10.1007/s00296-015-3409-8

    Article  CAS  PubMed  Google Scholar 

  67. Vreju FA, Filippucci E, Gutierrez M et al (2016) Subclinical ultrasound synovitis in a particular joint is associated with ultrasound evidence of bone erosions in that same joint in rheumatoid patients in clinical remission. Clin Exp Rheumatol 34:673–678

    PubMed  Google Scholar 

  68. Han J, Geng Y, Deng X, Zhang Z (2016) Subclinical synovitis assessed by ultrasound predicts flare and progressive bone erosion in rheumatoid arthritis patients with clinical remission: a systematic review and metaanalysis. J Rheumatol 43:2010–2018. https://doi.org/10.3899/jrheum.160193

    Article  PubMed  Google Scholar 

  69. Naredo E, Valor L, De la Torre I et al (2015) Predictive value of Doppler ultrasound-detected synovitis in relation to failed tapering of biologic therapy in patients with rheumatoid arthritis. Rheumatology (Oxford) 54:1408–1414. https://doi.org/10.1093/rheumatology/kev006

    Article  Google Scholar 

  70. Kawashiri SY, Fujikawa K, Nishino A et al (2017) Ultrasound-detected bone erosion is a relapse risk factor after discontinuation of biologic disease-modifying antirheumatic drugs in patients with rheumatoid arthritis whose ultrasound power Doppler synovitis activity and clinical disease activity are well controlled. Arthritis Res Ther 19:108. https://doi.org/10.1186/s13075-017-1320-2

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Clinica Reumatologica, Università Politecnica delle Marche, Ospedale “Carlo Urbani”, Via Aldo Moro, 25, 60035, Jesi, Ancona, Italy

    Emilio Filippucci, Edoardo Cipolletta, Fausto Salaffi, Marika Tardella, Andrea Di Matteo & Marco Di Carlo

  2. Dipartimento Diagnostica per Immagini, ULSS 6 Euganea, Ospedale di Cittadella, Casa di Ricovero, 40, 35013, Cittadella, Padova, Italy

    Riccardo Mashadi Mirza

  3. Radiology Department, Università Politecnica delle Marche, Ospedali Riuniti di Ancona, Via Conca, 71, 60126, Ancona, Italy

    Marina Carotti & Andrea Giovagnoni

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  1. Emilio Filippucci
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Correspondence to Emilio Filippucci.

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E.F. has received personal fees from AbbVie, Bristol-Myers Squibb, Celgene, Roche and UCB Pharma. R.M.M has received personal fees from Bracco. A.D.M has received personal fees from Grunenthal. M.D.C. reports personal fees from AbbVie and Novartis. All other authors have declared no conflicts of interest.

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Filippucci, E., Cipolletta, E., Mashadi Mirza, R. et al. Ultrasound imaging in rheumatoid arthritis. Radiol med 124, 1087–1100 (2019). https://doi.org/10.1007/s11547-019-01002-2

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