Two Powerful Refreshers on the Diagnosis and Monitoring of Rheumatoid Arthritis

Besides heralding the start of warmer weather for many of us, May is a month with a different purpose—Arthritis Awareness.

Arthritis comes in many forms. Nearly 53 million adults are affected by arthritis, and that number is expected to grow to 67 million by 2030. According to, people with osteoarthritis and rheumatoid arthritis miss a combined 172 million workdays per year (Arthritis Foundation, 2016).

One of the most serious forms of arthritis is rheumatoid arthritis (RA). It is an autoimmune disease that causes the body’s immune system to attack the joints. This causes layers of cartilage between the joints to diminish, making any movement very painful and inflammatory. If the disease is not identified and treated early, it can cause irreversible damage, including joint deformity. RA is even more serious than that because although it causes extreme pain in joints, it can also affect the cardiovascular and respiratory systems (Arthritis Foundation, 2016).

By ensuring you have the right study for the most proper and complete diagnosis, you can help ease current pain, and prevent future problems of a more serious nature.

The Right Modality

Specific imaging is a good tool in proper and complete diagnosis of RA. Use MRI instead of traditional radiography (x-ray) to identify the disease and its trajectory in a patient initially. This is because MRI can show subtleties that a typical x-ray cannot. It can identify earlier stages of RA in greater detail than traditional radiography.

Ultrasound is often most effective in follow-up exams, as it can help detect fine synovial changes and help keep track of the disease’s progression.

MRI is a more sensitive, soft-tissue imaging modality (RSNA, 2010). Despite being more time-consuming and expensive than some other modalities, it is very important for early detection. On the radiologist’s side, this means before any truly destructive changes occur.

Taking this a step further, imaging professionals can use multiplanar and other orthopedic tools to further identify and diagnose.

The Right Tools

It is one thing to properly identify RA, it is another to monitor it over time.

A good enterprise imaging system will provide you with a suite of orthopedic tools that enable you to track progression and small differences between imaging studies. For example, NovaPACS includes multiplanar imaging, which is very useful in diagnosing and monitoring the onset of RA.

According to the Radiological Society of North America, “axial and sagittal imaging should be performed on the basis of coronal images to correctly define pathologic changes.” The multiplanar approach is especially useful in distinguishing between erosions and pre-erosive changes.

What Else Can You Do?

There are many ways to show your support for those in the fight against arthritis, and for you to support it yourself. Visit for a list of basic ways you (and your facility) to participate in Arthritis Awareness. If you want to help inform your patients, you could assemble a blog post or article similar to this one from Northwestern Medical Imaging.


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