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Rheumatoid Arthritis Case Study

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The Role of Imaging in Rheumatoid Arthritis

Rheumatoid arthritis (RA), is a chronic, systemic inflammatory disease of unknown etiology that affects 0.5-1.0% of the general population [1]. It is the most common type of inflammatory arthritis and is characterized by synovial inflammation that can lead to structural damage of cartilage, bone and tendons [15]. There has been increasing evidence that the early use of disease-modifying anti-rheumatic drug (DMARD) leads to better outcomes [2]. However to be able to treat patients early they need to be diagnosed early and early diagnosis and treatment monitoring are the primary roles of imaging with regards to RA.

Diagnosis of RA is frequently done through clinical examination and patients with RA typically present with pain and stiffness in one or multiple joints. The wrists, metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joint are most commonly affected. However it is important to note that any synovial joint can be affected. The joints involved are usually bilateral and symmetric and women are more commonly affected than men. Characteristic deformities may also be seen in the hands. [11] CR:
Traditionally, radiographs are used for evaluating RA and the …show more content…
It is used as a standard reference for detecting bone erosions in RA. On of the advantages of using CT over conventional radiography is that you can create a three-dimensional reconstruction of the joint whereas conventional radiography only give two-dimensional images. However CT cannot be used to adequately visualize soft tissue changes, and magnetic resonance imaging (MRI) and ultrasound (US) are still superior in that regard. CT is rarely used in clinical practice although it appears to be more sensitive than MRI for detecting bone erosions and so it may have an unexplored potential as an assessment method for joint damage in patients with RA.

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