Imaging outcomes and their role in determining outcomes in osteoarthritis and rheumatoid arthritis.
OBJECTIVE
This review describes the advances in knowledge of outcomes that have occurred recently as a result of imaging research in both osteoarthritis and rheumatoid arthritis.


RESULTS
Recent imaging advances in osteoarthritis have offered insights into fundamental questions including the cause of pain and reasons for disease progression. Although ongoing disease modification clinical drug trials in osteoarthritis mostly use standardized plain radiographs to monitor structural changes in the joint, magnetic resonance imaging is rapidly evolving as a method of monitoring joint structure and with time may become the preferred method of monitoring this feature in osteoarthritis clinical trials. The past decade has seen major advances in the treatment of rheumatoid arthritis in which imaging determines whether individual agents or therapeutic regimens are structure modifying. Although conventional radiography remains the gold standard for assessing structural progression in rheumatoid arthritis, growing work on the performance metrics of magnetic resonance imaging has resulted in its increasing use in trials. Ultrasonography shows preliminary promise as a useful outcome measure.


CONCLUSIONS
Recent advances in imaging are improving our understanding of the etiopathogenesis and treatment of persons with osteoarthritis and rheumatoid arthritis. Complex challenges face us over the coming years as clinicians and researchers grapple with the use of these new techniques, the insights they may provide, and their clinical application.
Hunter
David J
DJ
Boston University Clinical Epidemiology Research and Training Unit, and the Department of Medicine at Boston Medical Center, Boston, Massachussetts 02118, USA. djhunter@bu.edu
Conaghan
Philip G
PG
D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000188:drug therapy*; D003952:Diagnostic Imaging / Q000379:methods / Q000639:trends*; D018450:Disease Progression; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000639:trends; D010003:Osteoarthritis / Q000175:diagnosis* / Q000188:drug therapy*; D011237:Predictive Value of Tests; D011379:Prognosis; D011859:Radiography / Q000379:methods / Q000639:trends; D014463:Ultrasonography / Q000379:methods / Q000639:trends