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| UDK 616.72-002.77-073.7 |
ISSN 035-2899, 38(2013) br.4 p.203-209 |
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Review article The role of the imaging methods in measuring
disease activity and joint damage Siniša Ristić, Maja Račić |
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| Download in pdf format | Summary: Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease of unknown cause, which primarily involves synovial membrane of joints in genetically predisposed individuals. It has been shown in several studies that a global assessment of disease activity, frequently used in clinical practice by rheumatologists, is less sensitive compared with clinical disease activity measures or compared with inflammation assessed by ultrasound. Many instruments are available to assess disease activity in inflammatory diseases. A core set for RA disease activity assessment includes three visual analogue scales; the doctor and patient global assessment of disease activity and patient perception of pain, two joint counts, a measure of active phases reactants, a measure for function and a measure for damage in trials of at least 12 months duration. Despite the fact that conventional radiography is limited to visualization of bone structures, it is the imaging method most widely used in the diagnosis of RA and to follow the course of the disease and effectiveness of treatment, due to accessibility and relatively low cost. Magnetic resonance imaging (MRI) and ultrasonography (US) are higly sensitive techniques that allow direct visualisation of early inflammatory as well as early destructive joint changes in RA. MRI synovitis and bone edema are sensitive to change and have been shown to predict subsequent erosive progression. Using MRI for RA activity assessment purposes is significantly limited due to lower availability and increased cost, so in clinical practice it is usually provided to patients with normal radiographs. Compared with MRI, ultrasound sensitivity is approximately equal in diagnosing changes in the joints of the fingers, knees and hips, but decreased in the visualization of inflammatory changes of complex joints. There is a need to find an ultrasound score, which would quantify the observed inflammatory changes in rheumatoid arthritis. Keywords: reumathoid arthritis, disease activity, core set, ultrasound, Napomena: kompletan tekst rada na srpskom jeziku Note: full text in Serbian |
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Corresponding Address: Siniša Ristić; Studentska 5, 73300 Foča, Bosna i Hercegovina; E-mail: porodicnamedicina@gmail.com |
Paper received: 17.12.2013 Paper accepted: 25.12.2013 Paper Internet issues: 14.3.2013 |
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