Abstract:
Conventional radiographs of the hands and feet have traditionally been used in the diagnosis,
management and monitoring of patients with rheumatoid arthritis (RA). However, they are
not sensitive enough to detect changes early in the disease process. Erosions may only be
visible up to two years after the onset of disease, and soft tissue involvement may not be
detected at all. Early diagnosis can also be made challenging as markers such as erythrocyte
sedimentation rate and C-reactive protein may be normal in up to 20% – 25% of cases. The latest
classification criteria (American College of Rheumatology/European League Against
Rheumatism [ACR/EULAR] Rheumatoid Arthritis Classification criteria 2010), often used to
diagnose RA, incorporate the role of ultrasound and magnetic resonance imaging detection of
synovitis, enabling earlier diagnosis and correct classification of patients. This article looks at
the role of the various imaging modalities used in the diagnosis and management of RA.
