Rubin David A
Department of Radiology, Washington University School of Medicine, 510 South Kingshighway Blvd., St. Louis, MO, 63110, USA.
Skeletal Radiol. 2019 Jun;48(6):837-857. doi: 10.1007/s00256-019-03180-6. Epub 2019 Feb 26.
Advanced imaging has become just as vital for diagnosing, staging, and monitoring disease in rheumatoid arthritis (RA) patients as it is for cancer patients. Part 1 of this review discussed synovitis, tenosynovitis, erosions, and osteitis-key imaging findings that occur in patients with RA. Part 2 will now show how these features, in combination with clinical and serologic data, can assist clinical decision-making at various stages of a patient's disease course. Specifically, assessing current disease activity and prognosticating future aggressiveness inform treatment decisions at initial presentation, during medical treatment, and at clinical remission. In addition to summarizing the current literature on advanced imaging in RA, clinical examples from different stages throughout the disease course will illustrate practical approaches for applying these research results. Last, this review will describe potential future roles of imaging in RA patients.
先进成像技术对于类风湿关节炎(RA)患者的疾病诊断、分期及监测而言,已与癌症患者一样至关重要。本综述的第1部分讨论了滑膜炎、腱鞘炎、侵蚀及骨炎——RA患者的关键影像学表现。第2部分将展示这些特征如何与临床及血清学数据相结合,在患者疾病进程的不同阶段辅助临床决策。具体而言,评估当前疾病活动度及预测未来侵袭性可为初始就诊、药物治疗及临床缓解期的治疗决策提供依据。除了总结关于RA先进成像技术的当前文献外,来自疾病全程不同阶段的临床实例将阐明应用这些研究结果的实用方法。最后,本综述将描述成像技术在RA患者中的潜在未来作用。