Rheumatoid arthritis

Since the advent of disease-modifying antirheumatic drugs for the treatment of rheumatoid arthritis, there has been an increasing emphasis on the early diagnosis and monitoring of this condition. This has led to the greater involvement of advanced imaging techniques such as ultrasound and MRI. Ultrasound appearances of common findings in rheumatoid arthritis are discussed in this review. Comparison of ultrasound in terms of sensitivity and specificity with other imaging modalities and with clinical examination is also made. Quantification is also discussed as a tool to allow assessment of response to drug therapy, an area that is likely to progress further as techniques become increasingly reproducible. Finally, as ultrasound techniques continue to develop, its involvement in the management of patients with rheumatoid arthritis is increasing. New techniques such as fusion imaging and sonoelastography, while at present still largely research-based entities, may offer increasingly improved diagnostic benefits in the field of inflammatory arthropathy.