Diagnosis of rheumatoid arthritis has become critical as evidence accrues that the earlier the treatment is given, the better the outcome.
Imaging has a crucial role to play in enabling earlier diagnosis.
Identify erosions when x-rays are normal.
Can change the diagnosis by identifying sub-clinical inflamation which allows the requisite number of joints to be identified as synoptic for the diagnosis of RA to be fulfilled.
For monitoring, imaging can assess whether a response to therapy has occurred, when it is difficult to assess clinically, and therefore can lead to continuation or discontinuation of therapy at an earlier stage with benefits for patient and for costs. For patients who have reached stable state it is possible assess whether they have suppressed inflammation completely, in which case dose reduction can be considered or if not whether further therapy is required. The evidence that further therapy impacts on long-term outcome is being investigated.
Disclosure of Interest None declared