2023 EULAR recommendations on imaging in diagnosis and management of crystal-induced arthropathies in clinical practice

Abstract

ObjectiveTo formulate evidence-based recommendations and overarching principles on the use of imaging in the clinical management of crystal-induced arthropathies (CiAs).MethodsAn international task force of 25 rheumatologists, radiologists, methodologists, healthcare professionals and patient research partners from 11 countries was formed according to the EULAR standard operating procedures. Fourteen key questions on the role of imaging in the most common forms of CiA were generated. The CiA assessed included gout, calcium pyrophosphate deposition disease and basic calcium phosphate deposition disease. Imaging modalities included conventional radiography, ultrasound, CT and MRI. Experts applied research evidence obtained from four systematic literature reviews using MEDLINE, EMBASE and CENTRAL. Task force members provided level of agreement (LoA) anonymously by using a Numerical Rating Scale from 0 to 10.ResultsFive overarching principles and 10 recommendations were developed encompassing the role of imaging in various aspects of patient management: making a diagnosis of CiA, monitoring inflammation and damage, predicting outcome, response to treatment, guided interventions and patient education. Overall, the LoA for the recommendations was high (8.46–9.92).ConclusionsThese are the first recommendations that encompass the major forms of CiA and guide the use of common imaging modalities in this disease group in clinical practice.

Greetings from the editor 2024/2

“…But when you read these 'Greetings', you will already have seen the regular ARD June issue published at the time of the Congress. It has become customary that ARD provides some of the most recent EULAR recommendation papers in the congress-issues, and so it is this time covering a broad range of topics of direct relevance to clinical practice comprising updates of the EULAR recommendations for the management of psoriatic arthritis 8 9 ; for imaging in vasculitis 10 ; for non-pharmacological management of hip and knee osteoarthritis 11 ; as well as new recommendations for imaging in crystal diseases 12 and nonpharmacological management of patients with systemic lupus erythematosus and systemic sclerosis. 13 You may remember that in my January Greetings I highlighted several anniversaries to commemorate in 2024, 1 among them the publication of the seminal paper on the treatment of RA with glucocorticoids 75 years ago.…”