Imaging in rheumatoid arthritis: the role of magnetic resonance imaging and computed tomography.
Mikkel ØstergaardMikael BoesenPublished in: La Radiologia medica (2019)
In suspected and diagnosed rheumatoid arthritis (RA), magnetic resonance imaging (MRI) allows detection of all relevant pathologies, such as synovitis, tenosynovitis, bone marrow edema (osteitis), bone erosion and cartilage damage. MRI is more sensitive than clinical examination for monitoring disease activity (i.e., inflammation) and more sensitive than conventional radiography and ultrasonography for monitoring joint destruction. In suspected RA, MRI bone marrow edema predicts development of RA, and in early RA patients, it predicts subsequent structural damage progression. CT is the standard reference imaging modality for visualizing bone damage, including bone erosions in RA, but lacks sensitivity for soft-tissue changes, including synovitis and tenosynovitis. CT has a minimal role in RA clinical trials and practice, except in selected patients where MRI is contraindicated or not available or if crystal arthritis such as gout or pseudo-gout is suspected. MRI has documented utility in diagnosis, monitoring and prognostication of patients with RA and is increasingly used for these purposes in clinical practice and particularly clinical trials.
Keyphrases
- rheumatoid arthritis
- contrast enhanced
- disease activity
- magnetic resonance imaging
- computed tomography
- ankylosing spondylitis
- systemic lupus erythematosus
- bone marrow
- diffusion weighted imaging
- clinical trial
- rheumatoid arthritis patients
- end stage renal disease
- soft tissue
- magnetic resonance
- interstitial lung disease
- oxidative stress
- juvenile idiopathic arthritis
- positron emission tomography
- high resolution
- dual energy
- newly diagnosed
- chronic kidney disease
- prognostic factors
- peritoneal dialysis
- uric acid
- pulmonary embolism
- bone mineral density
- ejection fraction
- metabolic syndrome
- primary care
- patient reported outcomes
- sensitive detection
- phase ii
- fluorescent probe
- double blind
- quantum dots