Diagnostic radiography in rheumatoid arthritis: benefits and limitations

https://doi.org/10.1016/S0950-3579(96)80038-0Get rights and content

Summary

In the light of more modern techniques such as sonography and magnetic resonance imaging, the reader may well ask if plain radiography has still a role in the diagnostic work-up of rheumatoid arthritis. However, in daily routine, the value of diagnostic radiography in support of the clinical and laboratory diagnosis of rheumatoid arthritis is unrivaled. It allows differentiation from other joint diseases, such as osteoarthritis or crystal arthropathies, when the ARA criteria are not conclusive for the diagnosis of rheumatoid arthritis. Further, plain radiography is part of the basic documentation of the disease in measuring disease progression. Therapeutic decisions, such as systemic versus local therapy, and selection of drugs, as well as the form of local therapy, are heavily dependent on radiographs. However, the limitations of radiography in evaluating disease progression have to be recognized. Ultrasonography, as a “bedside method’, and MRI are indispensable adjuncts to radiography, because they are superior in detecting synovitis, early forms of cartilage damage as well as bone reaction such as erosions and cysts. A superior assessment of the degree of synovial changes is also possible with MRI.

References (17)

  • ArnettFC

    Revised criteria for the classification of rheumatoid arthritis

    Bulletin on the Rheumatic Diseases

    (1989)
  • ArnettFC et al.

    The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis

    Arthritis and Rheumatism

    (1988)
  • BrowerAC

    Use of the radiograph to measure the course of rheumatoid arthritis. The gold standard versus fool's gold

    Arthritis and Rheumatism

    (1990)
  • Foley-NolanD et al.

    Magnetic resonance imaging in the assessment of rheumatoid arthritis—a comparison with plain film radiographs

    British Journal of Radiology

    (1991)
  • GaffneyK et al.

    Quantification of rheumatoid synovitis by magnetic resonance imaging

    Arthritis and Rheumatism

    (1995)
  • KayeJJ

    Arthritis: roles of radiography and other imaging techniques in evaluation

    Radiology

    (1990)
  • KayeJJ et al.

    Problems with the Steinbroker staging system for radiographic assessment of the rheumatoid hand and wrist

    Investigative Radiology

    (1990)
  • KremerJM et al.

    Long term prospective study of the use of methotrexate in the treatment of rheumatoid arthritis update after a mean of 90 months

    Arthritis and Rheumatism

    (1992)
There are more references available in the full text version of this article.

Cited by (0)

View full text