TY - JOUR T1 - Imaging of the hand and wrist in RA JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - 867 LP - 869 DO - 10.1136/ard.61.10.867 VL - 61 IS - 10 AU - B Taouli AU - A Guermazi AU - K E Sack AU - H K Genant Y1 - 2002/10/01 UR - http://ard.bmj.com/content/61/10/867.abstract N2 - Interrelationships and comparisons of imaging with clinical disease activity In the past decade, elucidation of pathophysiological pathways relevant in rheumatoid arthritis (RA) has continued, leading to continuing advances in drug treatment. At the same time, several clinical trials have shown the efficacy of early and aggressive treatment of patients with active disease. Early intervention strategies may reduce functional deterioration and improve long term outcome. Therefore, treatment strategies need to be determined before irreversible damage and functional deterioration occur. Imaging techniques are useful not only for studying the natural history of the disease but also for assessing the response to disease modifying antirheumatic drugs, and—potentially—for selecting those patients who will benefit most from early aggressive treatment. Conventional or digitised radiography of the hand and wrist is the traditional method used to diagnose, determine the stage, and monitor patients with RA, and to assess treatment efficacy in individual patients. Radiography, using several scoring systems, is also pivotal for the evaluation of disease progression and treatment efficacy in RA clinical trials,1–3 with excellent intra- and interobserver agreement.1,4 However, radiography is insensitive in detecting early erosions, and above all, in assessing synovitis. Recently, more powerful and complex imaging modalities have emerged as alternatives or additions to radiography. These include magnetic resonance imaging (MRI)5–11 and ultrasound (US).5,12–18 Several studies have shown the relative usefulness of MRI over radiography in evaluating early RA of the hand … ER -