Imaging the joints in early rheumatoid arthritis

Radiography is the most widely utilized imaging modality for early rheumato id arthritis, determination of radiographic progression remaining a crucial part of the evaluation of therapy. Conventional radiography is, however, i nsensitive for showing bone damage in early disease and is totally unsuitab le for assessing synovial inflammation. The recognition of these limitation s has led to intense interest in the multiplanar imaging capabilities of ma gnetic resonance imaging in rheumatoid arthritis and to an increasing use o f ultrasonography for assessing synovitis and bone damage. This chapter dis cusses the role of radiography in early rheumatoid arthritis and the emergi ng use and role of magnetic resonance imaging and ultrasonography in evalua ting synovitis and bone damage. The relationship between synovitis and bone damage is also addressed in the light of recent magnetic resonance imaging observations.