If you’ve recently been diagnosed with rheumatoid arthritis, how can you judge the severity of your condition? While the number of joints involved and presence of inflammation in other organs outside of the joints are useful variables, imaging studies are the main method of evaluating severity of disease.
Traditionally X-rays were the first line imaging modality used, and they still are. But in reality X-rays are only good at showing chronic disease damage in RA. They can not determine degree of activity, xrays are essentially only useful at evaluating bones, which in RA become damaged over time. A much better option is either ultrasound or MRI. Both these modalities detect damage earlier compared to X-rays. In addition both ultrasound and MRI can determine whether your condition is actively inflamed which X-rays can not.
Ideally MRI would be available to screen for damage in all our RA patients due its slightly better sensitivity in detecting damage compared to ultrasound. Due to significant cost differences, ultrasound is the test of choice in most RA patients. Cost effective and extremely sensitive in detecting damage and recognizing active disease, ultrasound should be the rheumatologists first choice of imaging study in all RA patients.