Musculoskeletal Techniques and Ultrasound Unit

Musculoskeletal ultrasound is a non-invasive technique allowing structures to be assessed in real time, which enables precise diagnosis and monitoring of rheumatic disorders. It has become a highly useful, essential tool in the field of rheumatology.

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It is a benchmark unit and has a consolidated research line with more than 10 projects in various illnesses, such as rheumatoid arthritis, psoriatic arthritis, Sjögren’s syndrome, arthrosis, rheumatic polymyalgia and Horton's arteritis. Specific training is given to Rheumatology resident doctors, both from our hospital and from outside, and has accredited professionals who are also professors at the Spanish Rheumatology Society’s Ultrasound School (adults and paediatrics).

The main work carried out by our unit is:

• Musculoskeletal ultrasound, to diagnose and monitor rheumatic conditions, and also monitor therapeutic effectiveness.
• Interventional ultrasound, based on ultrasound-guided joint, or periarticular soft tissue, punctures. Therefore we do synovial fluid arthrocentesis (diagnosis) and joint or soft tissue infiltrations with corticosteroids or hyaluronic acid, depending on each patient’s pathology (treatment).
• Non-joint ultrasound:
  • Temporal artery ultrasound, which is highly useful if Horton’s arteritis or arteritis of other arterial vessels is suspected. 
  • Salivary glands ultrasound, to assess dry mouth syndrome and Sjögren’s syndrome.
  • Pulmonary ultrasound, to assess possible secondary pulmonary involvement in rheumatic diseases.
• Video capillaroscopy: for Raynaud’s phenomenon assessment and diagnosis
• Synovial biopsy, guided by ultrasound, to diagnose certain types of arthritis.
• Arthrocentesis and joint/periarticular infiltrations. These can be done with ultrasound guidance, or without it, depending on the complexity. 

In collaboration with the Radiodiagnosis department and Nuclear Medicine, the images obtained from simple X-rays, CAT scans, Nuclear magnetic resonance and bone scintigraphy are interpreted with the aim of establishing the diagnosis or monitoring of patients with inflammatory disorders. We also hold regular joint meetings to analyse complex cases.

Various valuable techniques are also performed at the Musculoskeletal Techniques and Ultrasound Unit (MTU) to diagnose various systemic joint and autoimmune inflammatory illnesses, such as:

• Subcutaneous fat biopsy, if amyloidosis is suspected.
• Schirmer and Saxon tests to assess dry mouth or eye syndrome/Sjögren’s syndrome
• Pathergy test, in the event that Behçet’s disease is suspected.
• Microscopic analysis of synovial fluid obtained with arthrocentesis.