MRI in assessment of the systemic manifestations of rheumatological disease

Magnetic resonance imaging (MRI) has emerged as complementary imaging modality to conventional radiography. The same diagnostic rules that are used in the interpretation of the routine radiographs should be applied to the analysis of MR images with the macroscopic spread of the disease as a main diagnostic clue. MRI has been shown to be a sensitive tool in detecting early arthritic changes and erosions, inflammation in periarticular tendons and tendon sheaths, and in juxtaarticular bursae. MRI plays a pivotal role in diagnosis of arthritis of the craniocervical junction and its complications. It also has been used effectively to detect insufficiency fractures and osteonecrosis. MRI may be important in diagnosing early arthritis, in specifying the differential diagnosis of rheumatic disease, and in selecting subgroups of patients to provide tailored therapeutic regimens.