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The Importance of Testing for Rheumatoid Arthritis

The first two years a patient has rheumatoid arthritis are crucial. Without treatment early on, permanent joint damage can occur. In this report Dr. Kevin Moder reviews present day lab tests and imaging studies. He makes some predictions about the future use of such testing.

X-rays are used to start a baseline of how the joint looks but they don't show swelling of the joint lining (synovium). X-rays are done every few years to watch for changes. MRIs are more sensitive and show early joint changes when X-rays are normal.

Nuclear scans of the bones or joints detect synovitis in the joints or changes in the bone. A positive scan doesn't pinpoint the type of inflammatory process. It does help show what's going on in the joints when the patient is very obese.

Ultrasound studies called ultrasonography have several advantages. The patient is not exposed to any radiation. They show where the swelling is located and the presence of other problems such as cysts.

Doctors look to the future when patients who are at risk for RA will be identified a long time before the disease starts. Patients with a positive family history will be screened for an RA gene. By then there may be ways to prevent clinical disease. Improved technology will bring about sensitive, noninvasive imaging studies.

References: Kevin G. Moder, MD. Diagnostic Testing for RA: Current and Future Approaches. In The Journal of Musculoskeletal Medicine. October 2005. Supplement. Pp. S12-S17.

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