[Rheumatoid arthritis of the hand : Part 1: Clinical aspects].

BACKGROUND

All rheumatic autoimmune diseases are associated with arthritis of the hands, whereby it is possible to differentiate between typical and atypical arthritis patterns, which are key for diagnosis. Rheumatoid arthritis is commonly associated with synovitis of the hands. While patients with disease duration of less than 2 years were previously considered to have early disease, unfavorable prognosis with delayed initiation of therapy has reduced this time frame to 3 months after symptom onset.

OBJECTIVE

The aim is to provide radiologists with a systematic description of the clinical aspects of rheumatoid arthritis in order to better understand this entity so that they can confidently recognize arthritis patterns in the hands at an early stage.

MATERIALS AND METHODS

Narrative review based on the current literature on the subject from radiological and rheumatological point of view.

RESULTS

Synovitis of the hands is a common manifestation in rheumatoid arthritis. Knowledge of the epidemiology, prevalence, incidence, pathogenesis, genetics, etiology, biology and immunology, serology, histology, clinical presentation, the classification and diagnostic criteria, and therapy is essential for the radiologist to better understand the image-based morphologic changes associated with this complex disease and thereby gain greater confidence in the diagnosis of early stages.

CONCLUSIONS

For the diagnosis of rheumatoid arthritis, the radiologist must be familiar with basic clinical knowledge to confidently analyze the patterns present in arthritis of the hands at initial diagnosis and during the course of the disease, which are essential for therapy decisions.