For decades, X-ray images have been used to help detect rheumatoid arthritis (RA) and to monitor for the progression of bone damage. In early RA, however, X-rays may appear normal although the disease is active – making the films useful as a baseline but not much help in getting a timely diagnosis and treatment.
Enter modern imaging techniques, including ultrasound and magnetic resonance imaging (MRI), which can reveal early, non-bony signs of RA that are invisible on X-ray.
“Both MRI and ultrasound are more sensitive at detecting bone erosion than X-ray. In addition, they also reveal inflammation, which we could not see directly before and had to rely on blood tests and using our fingers to feel the joints,” says rheumatologist Philip Conaghan, MD, PhD, professor of musculoskeletal medicine at the University of Leeds and president of the International Society for Musculoskeletal Imaging in Rheumatology.