Portuguese recommendations for the use of ultrasound in rheumatology
Introduction: Ultrasound (US) is a relatively cheap, easily available and reliable method to improve the care of rheumatic patients. However, its use in rheumatology practice is very heterogeneous and needs to be standardized.
Objectives: To develop recommendations for the use of US in rheumatic diseases endorsed by the Portuguese Society of Rheumatology.
Methods: A systematic literature review of the available recommendations on the use of ultrasound in rheumatic diseases was performed and presented in a Portuguese Society of Rheumatology meeting to a subgroup of rheumatologists and rheumatology trainees with special interest in the subject. The most important topics to be addressed were selected and assigned to subgroups for literature review and draft recommendations. Following an iterative process of consensus, the final recommendations were developed, and their level of agreement voted anonymously online. A recommendation was approved when the average level of agreement was ≥ 7.5 in a 10-point Likert scale.
Results: Fourteen recommendations were produced regarding nine rheumatology topics: rheumatoid arthritis, spondyloarthritis, connective tissue diseases, polymyalgia rheumatica, vasculitis, crystal-deposition diseases, soft tissue rheumatism, osteoarthritis and ultrasound-guided procedures.
Conclusion: We developed an up-to-date guidance in the form of recommendations for the use of US in nine different areas of rheumatology. As ultrasound is an important imaging modality with increasing use in the rheumatology setting, and there are frequent technological advances in the ultrasound machines and probes, in parallel with continuous associated research, these recommendations should be regularly updated.
Guilherme Figueiredo
Hospital do Divino Espírito Santo, Ponta Delgada, Portugal
Fernando Saraiva
Hospital de Santa Maria, Centro Hospitalar e Universitário Lisboa Norte, Lisbon Academic Medical Centre, Lisboa, Portugal
António Vilar
Hospital dos Lusíadas, Lisboa, Portugal
Sandra Falcão
Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal and Faculdade de Ciência Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
Rui Teixeira
Hospital de Santa Maria, Centro Hospitalar e Universitário Lisboa Norte, Lisbon Academic Medical Centre, Lisboa, Portugal and Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
João Madruga-Dias
Cento Hospitalar Médio Tejo, Portugal
Margarida Oliveira
Centro Hospitalar e Universitário da Cova da Beira, Covilhã, Portugal and Universidade da Beira Interior, Portugal
Daniela Santos-Faria
Unidade Local de Saúde do Alto Minho, Ponte de Lima, Portugal
Carina Lopes
Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal.
Tiago Costa
Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal
Rita Barros
Hospital de Santa Maria, Centro Hospitalar e Universitário Lisboa Norte, Lisbon Academic Medical Centre, Lisboa, Portugal and Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
Margarida Cruz
Centro Hospitalar S. Francisco, Leiria, Portugal
Filipe Araújo
Hospital de Sant'Ana, SCML, Parede, Portugal
Marcos Cerqueira
Hospital de Braga, Braga, Portugal
Sara Serra
Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
Filipa Teixeira
Unidade Local de Saúde do Alto Minho, Ponte de Lima, Portugal
Cristina Ponte
Hospital de Santa Maria, Centro Hospitalar e Universitário Lisboa Norte, Lisbon Academic Medical Centre, Lisboa, Portugal and Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
Joaquim Polido-Pereira
Hospital de Santa Maria, Centro Hospitalar e Universitário Lisboa Norte, Lisbon Academic Medical Centre, Lisboa, Portugal and Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
Hospital do Divino Espírito Santo, Ponta Delgada, Portugal
Fernando Saraiva
Hospital de Santa Maria, Centro Hospitalar e Universitário Lisboa Norte, Lisbon Academic Medical Centre, Lisboa, Portugal
António Vilar
Hospital dos Lusíadas, Lisboa, Portugal
Sandra Falcão
Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal and Faculdade de Ciência Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
Rui Teixeira
Hospital de Santa Maria, Centro Hospitalar e Universitário Lisboa Norte, Lisbon Academic Medical Centre, Lisboa, Portugal and Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
João Madruga-Dias
Cento Hospitalar Médio Tejo, Portugal
Margarida Oliveira
Centro Hospitalar e Universitário da Cova da Beira, Covilhã, Portugal and Universidade da Beira Interior, Portugal
Daniela Santos-Faria
Unidade Local de Saúde do Alto Minho, Ponte de Lima, Portugal
Carina Lopes
Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal.
Tiago Costa
Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal
Rita Barros
Hospital de Santa Maria, Centro Hospitalar e Universitário Lisboa Norte, Lisbon Academic Medical Centre, Lisboa, Portugal and Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
Margarida Cruz
Centro Hospitalar S. Francisco, Leiria, Portugal
Filipe Araújo
Hospital de Sant'Ana, SCML, Parede, Portugal
Marcos Cerqueira
Hospital de Braga, Braga, Portugal
Sara Serra
Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
Filipa Teixeira
Unidade Local de Saúde do Alto Minho, Ponte de Lima, Portugal
Cristina Ponte
Hospital de Santa Maria, Centro Hospitalar e Universitário Lisboa Norte, Lisbon Academic Medical Centre, Lisboa, Portugal and Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
Joaquim Polido-Pereira
Hospital de Santa Maria, Centro Hospitalar e Universitário Lisboa Norte, Lisbon Academic Medical Centre, Lisboa, Portugal and Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal