Stein M, et al. - This was a prospective, two-cohort, quasi-experimental study to compare the effectiveness of musculoskeletal US (MSUS) to routine care (RC) as a disease management tool in individuals with moderate-to-severe RA requiring a treatment change due to lack of efficacy. The predictive value of MSUS was also evaluated. The study population consisted of 383 individuals (MSUS: n = 171; RC: n = 212). A greater proportion of MSUS individuals were treated with a biologic DMARD while more individuals treated per RC received a non-biologic DMARD at baseline. The results showed that a greater number of RA treatment modifications were used in the MSUS group in comparison with RC, including steroids, non-biologic DMARDs and biologic DMARDs during follow-up. For the detection of subclinical levels of inflammation and prediction of future joint deterioration, MSUS assessments can be beneficial, therefore allowing optimization of RA treatment and individual care.