Imaging in rheumatology

Imaging plays a vital role in the diagnosis and management of hematological disorders. Traditionally, plain film radiography was widely used in arthropathies to assess per articular bony changes. These often reflect established changes in the late stage of disease and thus have limited value in early diagnosis and disease monitoring. Magnetic resonance imaging (MRI) and ultrasound scanning are being used increasingly for the early diagnosis of arthropathies. MR techniques such as dGEMRIC and sodium MRI are used for the physiologic imaging of articular cartilage. These offer the potential for the diagnosis of early osteoarthritis and for assessment following treatment. Whole-body MRI is useful in the assessment of multifocal and systemic rheumatic diseases.Morphological MRI has been used to assess inflammatory joint disease. It plays a substantial role in early diagnosis, monitoring of disease evolution, Assessment of treatment responses and prognostication. Ultrasound scanning has the advantage of being low cost and provides dynamic imaging. On an ultrasound scan, proliferative synovitis is seen as distension of the joint capsule by hypo echoic tissue with increased blood flow on Doppler imaging. Ultrasound scanning is excellent for the detection of peripheral enteritis, a feature of seronegative arthropathies.