[Imaging beyond conventional radiography: mini arthroscopy, duplex ultrasonography and positron emission tomography]

Imaging procedures, such as ultrasound and magnetic resonance imaging have broadened the diagnostic spectrum by "visualization" of pathomorphologic changes in rheumatic diseases. The advantages of these techniques are sectional imaging and three dimensional illustration, which enhance the exact detection of inflammatory soft tissue alterations and the sensitive and early detection of bony changes. Most current techniques and methods such as mini arthroscopy, color and power Doppler ultrasonography and positron emission tomography (PET) complete the set of diagnostic tools for rheumatologists, when other diagnostics reach their limits. Doppler ultrasonography and PET detect and assess inflammatory changes of systemic diseases locally and on the whole, which were not visible by standard diagnostic procedures. Mini arthroscopy furnishes, besides the direct evaluation of the joint, access to the pathomorphologic substrate itself with the opportunity of tissue sampling and further molecular biological analysis. These new diagnostic techniques open a widespread goal for rheumatologists in terms of etiopathogenesis, early diagnosis and monitoring of inflammatory rheumatic diseases.