Aspects of the radiological evaluation of rheumatoid arthritis

Abstract

This paper gives an overview of several aspects of the radiographic evaluation of rheumatoid arthritis (RA). Radiographs give important information about the structural damage caused by RA. On a group level, the natural progression follows a rather linear cause, but on an individual patient level, this can vary widely. Feet are often affected earlier and to a larger extent than hands. Both hands and feet give a good overall impression of the damage in the large joints and are sufficient to monitor the patient. It is recommended to take annual films of hands and feet to monitor patients. Several scoring methods are available for application in clinical trials. Most widely used are the Sharp and Larsen methods with their modifications. For use in clinical practice the SENS method is more feasible. Several drugs are capable of retarding radiographic progression. However, it is difficult to compare results across trials and these difficulties are elaborated.