OBJECTIVE: To identify and synthesize the best available evidence on the application of musculoskeletal (MSK) ultrasound (US) in patients with systemic lupus erythematosus (SLE) and to present the measurement properties of US in different elementary lesions and pathologies. METHODS: A systematic literature search of PubMed, Embase, and the Cochrane Library was performed. Original articles were included that were published in English between August 1, 2014, and December 31, 2018, reporting US, Doppler, synovitis, joint effusion, bone erosion, tenosynovitis, and enthesitis in patients with SLE. Data extraction focused on the definition and quantification of US-detected synovitis, joint effusion, bone erosion, tenosynovitis, enthesitis, and the measurement properties of US according to the OMERACT Filter 2.1 instruments selection. RESULTS: Of the 143 identified articles, 15 were included. Most articles were cross-sectional studies (14/15, 93%). The majority of the studies used the OMERACT definitions for ultrasonographic pathology. Regarding the measurement properties of US in different elementary lesions and pathologies, all studies dealt with face validity, content validity, and feasibility. Most studies achieved construct validity. Concerning the reliability of image reading, 1 study (1/15, 7%) assessed both intraobserver and interobserver reliability. For image acquisition, 4 studies (4/15, 27%) evaluated interobserver reliability and none had evaluated intraobserver reliability. Criterion validity was assessed in 1 study (1/15, 7%). Responsiveness was not considered in any of the studies. CONCLUSION: This literature review demonstrates the need for further research and validation work to define the involvement of US as an outcome measurement instrument for the MSK manifestations in patients with SLE.

From the Division of Rheumatology Department of Medicine and Therapeutics The Chinese University of Hong Kong; Department of Medicine Hong Kong Sanatorium and Hospital Hong Kong SAR China; Rheumatology Unit University of Pisa Pisa Italy; Department of Rheumatology Institute of Rheumatology Prague Czech Republic; Division of Rheumatology School of Medicine Marmara University Istanbul Turkey; Rheumatology Department Cavale Blanche Hospital and Brest Occidentale University Brest; Department of Rheumatology AP HP Hôpital Ambroise Paré Rheumatology Department Boulogne Billancourt; INSERM U1173 Laboratoire d'Excellence INFLAMEX UFR Simone Veil Versailles Saint Quentin University Saint Quentin en Yvelines France; Department of Rheumatology and Clinical Immunology Charite University Hospital Berlin Germany; Department of Rheumatology Université Catholique de Louvain Institut de Recherche Expérimentale et Clinique Cliniques Universitaires Saint Luc Brussels Belgium; School of Medicine and Pharmacology University of Western Australia Perth Australia; Center for Rheumatology and Spine Diseases Rigshospitalet Copenhagen Denmark; Department of Rheumatology MC Groep Lelystad the Netherlands

P C Wong MD Division of Rheumatology Department of Medicine and Therapeutics The Chinese University of Hong Kong; G Lee MD Department of Medicine Hong Kong Sanatorium and Hospital; A Delle Sedie MD Rheumatology Unit University of Pisa; P Hanova MD PhD Department of Rheumatology Institute of Rheumatology; N Inanc MD Division of Rheumatology School of Medicine Marmara University; S Jousse Joulin MD Rheumatology Department Cavale Blanche Hospital and Brest Occidentale University; S Ohrndorf MD Department of Rheumatology and Clinical Immunology Charite University Hospital; M S Stoenoiu MD PhD Department of Rheumatology Université Catholique de Louvain Institut de Recherche Expérimentale et Clinique Cliniques Universitaires Saint Luc; H 1 Keen MD PhD School of Medicine and Pharmacology University of Western Australia; L Terslev MD PhD Center for Rheumatology and Spine Diseases Rigshospitalet; M A D'Agostino MD PhD Department of Rheumatology AP HP Hôpital Ambroise Paré Rheumatology Department and INSERM U1173 Laboratoire d'Excellence INFLAMEX UFR Simone Veil Versailles Saint Quentin University; G A Bruyn MD PhD Department of Rheumatology MC Groep

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