Ultrasound Imaging of Joints in Rheumatoid Arthritis


Medical Author: William C. Shiel Jr., MD, FACP, FACR

A traditional method of monitoring the joint disease of patients with rheumatoid arthritis is "x-rays," whereby images are produced by exposing photographic film (radiographs). This technique has proven useful for doctors to follow the course of joint destruction. The early development of discrete bony destruction (erosions) is associated with more severe rheumatoid disease. While standard x-ray radiographs contribute substantially to the clinical evaluation of rheumatoid arthritis, they do lack some sensitivity early in the course of disease. This means that substantial joint destruction must happen before changes on the standard x-ray test become apparent.

Modern treatment for rheumatoid arthritis is frequently directed at early disease. Accordingly, there efforts to establish methods for early diagnosis of the disease have increased. Several radiographic imaging modalities have been explored including magnetic resonance imaging (MRI) and ultrasonography. MRI scanning has been found to be sensitive as an indicator of early rheumatoid joint destruction, but it is very expensive and not widely available. Ultrasonography is an attractive method of imaging because of its low cost, absence of harmful radiation, and rapidity of imaging. Recent advances in ultrasound image technology have allowed the development of sonographic equipment for imaging inflamed joints in patients with rheumatoid arthritis.