Are imaging techniques necessary for defining remission in rheumatoid arthritis?

Accurate assessment of inflammatory activity in rheumatoid arthritis (RA) is essential to evaluate response to therapy and disease remission. RA remission has been classically assessed by clinical and laboratory parameters. However, subclinical synovitis may explain progression of joint damage in spite of apparent clinical remission in RA patients. Imaging techniques, such as magnetic resonance imaging and high-resolution ultrasonography (US) with Doppler technique, provide a sensitive measure and monitoring of joint inflammatory activity and a more accurate assessment of RA remission than clinical evaluation which may contribute to make optimal treatment decisions. Within the last decade, an increasing number of rheumatologists have progressively incorporated musculoskeletal US as a valuable diagnostic tool in their clinical practice. This technique facilitates the scanning of all peripheral joints as many times as required at the time of consultation. Copyright (C) 2008 Elsevier Espana, S.L. All rights reserved.