Medical imaging and radiographic analysis of the rheumatoid patient.

According to the Arthritis Foundation, approximately 1.3 million Americans have rheumatoid arthritis (RA), while an estimated 300,000 children are diagnosed with the disease each year. The disease is 2- to 4-times more common in women than in men and is least common in young men. Current practices in the treatment of RA center on the early detection of the various disease manifestations, specifically joint destruction. The goal of early detection is the implementation of disease-modifying drugs before articular destruction and deformity set in. Advancements in medical imaging have led to methods that facilitate earlier detection and beneficial treatment in the course of RA. Because standard radiographic interpretation assists with diagnosis of later-stage arthritis after articular destruction has occurred, magnetic resonance imaging has proven to be the most effective study for early signs of RA. Other imaging modalities such as ultrasonography and contrast-enhanced computed tomography have also been shown to detect early signs of RA. In conjunction with laboratory testing, these imaging modalities are essential for the early detection and subsequent treatment of RA. Pedal imaging is used by most rheumatologists to detect and monitor disease progression, and by most podiatric surgeons to help direct treatment and plan surgical intervention.