An Update on Imaging in Rheumatoid Arthritis

Imaging update in inflammatory arthritis

“…Contemporary imaging of inflammatory arthropathies no longer relies on conventional radiography (CR) alone, but also includes ultrasound (US), magnetic resonance imaging (MRI), and in certain situations computed tomography (CT). 2 Most inflammatory rheumatic diseases are characterized primarily by systemic, synovial and bone inflammation (synovitis and osteitis) leading to joint destruction (cysts, erosions, cartilage damage). Among other key inflammatory features are: tenosynovitis, bursitis, enthesitis, and panniculitis, and in specific diseases the inflammation of muscles, fasciae, skin, subdermis, and nails.…”

“…Imaging is important to identify these major pathologies in order to aid the diagnosis and management. 2 The role of imaging methods differs depending on their sensitivity for specific tissues, ease of quantification, and feasibility of use. 2 The main tools to detect synovitis, tenosynovitis and bursitis, with sensitivity superior to the clinical examination, are US and MRI.…”

“…2 The role of imaging methods differs depending on their sensitivity for specific tissues, ease of quantification, and feasibility of use. 2 The main tools to detect synovitis, tenosynovitis and bursitis, with sensitivity superior to the clinical examination, are US and MRI. 2 The high resolution of US provides optimal multiplanar, static and dynamic evaluation of MSK soft tissue pathologies in peripheral joints.…”

“…2 The main tools to detect synovitis, tenosynovitis and bursitis, with sensitivity superior to the clinical examination, are US and MRI. 2 The high resolution of US provides optimal multiplanar, static and dynamic evaluation of MSK soft tissue pathologies in peripheral joints. MRI shows advantages in complex, three-dimensional evaluation of all joints of the peripheral and axial skeleton, and all tissues which may be affected by arthritis.…”

“…This includes the detection of bone marrow edema (BME) and inflammatory osteitis, which cannot be visualized with CR and US, but have been postulated as a precursor of bone erosions. 2 Bone erosions are among the cardinal features of RA, and their central role in the pathogenesis, diagnosis and prognosis of patients with the disease is widely recognized. 3 They have traditionally been considered as late-stage lesions, however, as several studies have shown that bone erosions might occur very early in the course of RA.…”