Imaging Updates in Rheumatoid Arthritis

Rheumatoid arthritis is a common chronic inflammatory arthritis, primarily characterized by proliferative synovitis of the small joints of the appendicular skeleton. Rapidly evolving treatment regimens for rheumatoid arthritis patients, including conventional and biologic disease-modifying antirheumatic drugs, promise improved quality of life and prognosis. These treatments necessitate earlier clinical detection of rheumatoid arthritis, a goal that has forever changed the role of imaging in this pursuit. This review discusses the dominant imaging modalities in state-of-the-art rheumatoid arthritis management: radiography, magnetic resonance imaging, and ultrasound. It focuses on hand and wrist evaluation, with key relevant findings detected by each modality and recent evidence supporting them. Emerging techniques are also described in this discussion to understand likely future radiologic contributions to rheumatoid arthritis diagnosis and management.