Imaging techniques in rheumatoid arthritis

Imaging methods have traditionally been the primary tools for documenting disease severity and progression. Radiographic methods are insensitive to early changes but eventually reflect the degree of bone destruction, cartilage space narrowing, and deformity that has occurred. Microfocal radiography is being investigated as a method to better define early erosive changes. Neither technique allows optimal examination of soft tissues (e.g., joint effusion, pannus, ligaments, and tendons). Magnetic resonance imaging (MRI) allows both soft tissues and bones to be examined. Articular cartilage imaging is currently under investigation. Despite its high cost, the noninvasive nature of MRI and the extensive information it provides, make this an exciting area for investigating the changes in rheumatoid arthritis and response to therapy.