Sometimes, patients need convincing.
A rheumatologist's nimble fingers, good looks, and confident persona may not be sufficient.
Do I really have rheumatoid arthritis? Why do I need medication? I'm not that bad.
I like my ultrasound machine in these circumstances. I can show this patient what's happening at the joint level.
Seeing your body part on screen in real time is powerful. Watching the moving images while the probe moves against skin is justification. It's even more convincing when the "red flames" of inflammation flicker into view.
Here's a series of screenshots from my ultrasound machine of an inflamed metacarpophalangeal joint (MCP or knuckle) in a patient with Rheumatoid Arthritis.
1st MCP joint (hand) showing synovitis (inflamed tissue)
The same joint, at a slightly different angle, showing erosive destruction
Now in power doppler mode. Showing abnormal blood vessels, signalling active inflammation.
Do you think this type of additional information is useful?
