title: EULAR recommendations for the use of imaging in the clinical management of peripheral joint osteoarthritis.
abstract: The increased information provided by modern imaging has led to its more extensive use. Our aim was to develop evidence-based recommendations for the use of imaging in the clinical management of the most common arthropathy, osteoarthritis (OA). A task force (including rheumatologists, radiologists, methodologists, primary care doctors and patients) from nine countries defined 10 questions on the role of imaging in OA to support a systematic literature review (SLR). Joints of interest were the knee, hip, hand and foot; imaging modalities included conventional radiography (CR), MRI, ultrasonography, CT and nuclear medicine. PubMed and EMBASE were searched. The evidence was presented to the task force who subsequently developed the recommendations. The strength of agreement for each recommendation was assessed. 17 011 references were identified from which 390 studies were included in the SLR. Seven recommendations were produced, covering the lack of need for diagnostic imaging in patients with typical symptoms; the role of imaging in differential diagnosis; the lack of benefit in monitoring when no therapeutic modification is related, though consideration is required when unexpected clinical deterioration occurs; CR as the first-choice imaging modality; consideration of how to correctly acquire images and the role of imaging in guiding local injections. Recommendations for future research were also developed based on gaps in evidence, such as the use of imaging in identifying therapeutic targets, and demonstrating the added value of imaging. These evidence-based recommendations and related research agenda provide the basis for sensible use of imaging in routine clinical assessment of people with OA.
authors.affiliation: Division of Rheumatology, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy.
authors.forename: Garifallia
authors.initials: G
authors.lastname: Sakellariou
authors.affiliation: Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and National Institute of Health Research Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.
authors.forename: Philip G
authors.initials: PG
authors.lastname: Conaghan
authors.affiliation: Academic Rheumatology, Clinical Sciences Building, University of Nottingham, Nottingham City Hospital, Nottingham, UK.
authors.forename: Weiya
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Johannes W J
authors.initials: JWJ
authors.lastname: Bijlsma
authors.affiliation: Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: Pernille
authors.initials: P
authors.lastname: Boyesen
authors.affiliation: APHP, Hôpital Ambroise Paré, Service de Rhumatologie, Boulogne-Billancourt, France.|INSERM U1173, Laboratoire d'Excellence INFLAMEX, Université Paris Ouest-Versailles St.-Quentin, Saint Quentin en Yvelines, France.
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: D'Agostino
authors.affiliation: Academic Rheumatology, Clinical Sciences Building, University of Nottingham, Nottingham City Hospital, Nottingham, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Doherty
authors.affiliation: 2nd Internal Medicine Department, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Daniela
authors.initials: D
authors.lastname: Fodor
authors.affiliation: Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
authors.forename: Margreet
authors.initials: M
authors.lastname: Kloppenburg
authors.affiliation: Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany.
authors.forename: Falk
authors.initials: F
authors.lastname: Miese
authors.affiliation: Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Esperanza
authors.initials: E
authors.lastname: Naredo
authors.affiliation: Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Porcheret
authors.affiliation: Rheumatology Unit, Dipartimento di Scienze Cliniche e BIologiche, Università degli Studi di Torino, Turin, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Iagnocco
mesh_terms: D026683:Advisory Committees; D005060:Europe; D033023:Foot Joints / Q000000981:diagnostic imaging*; D050823:Hand Joints / Q000000981:diagnostic imaging*; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D010003:Osteoarthritis / Q000000981:diagnostic imaging; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging*; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging*; D011859:Radiography; D011877:Radionuclide Imaging; D012219:Rheumatology; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
keywords: Magnetic Resonance Imaging; Osteoarthritis; Ultrasonography