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EULAR develops recommendations for imaging in patients with RA
Monitoring instability of a patient’s cervical spine by lateral radiography is among 10 imaging recommendations recently drafted by a European League Against Rheumatism task force for the clinical management of rheumatoid arthritis.
The task force, composed of 19 rheumatologists, radiologists, methodologists and rheumatology practitioners from 13 countries, compiled evidence-based guidelines that assessed imaging modalities of the joints in managing rheumatoid arthritis (RA). The researchers agreed upon 13 imaging-based questions before they compiled and evaluated study searches of Medline, Embase and Cochrane Central. Literature review included the following modalities: radiography, ultrasound, MRI, CT, dual-emission X-ray absorptiometry, digital X-ray radiogrammetry, scintigraphy and positron emission tomography.
After identifying 6,888 search references, researchers conducted a systematic review of 199 studies for inclusion. Through opinion and discussion, they reached consensus on 10 guidelines that they weighed and assigned by strength of recommendation (SOR) using a visual analog scale. Recommendations focused on the role of imaging in determining an RA diagnosis, detecting joint inflammation and damage, predicting treatment response and outcomes, monitoring disease activity, progression and remission. The endorsements were scored by perceived SOR that varied according to the level of research evidence and clinical expertise and opinions generated by the task force.
“These are the first recommendations produced by a EULAR task force on imaging in RA clinical practice,” the investigators wrote. “These are based on the best available evidence and clinical expertise supported by an international panel of experts. We aimed to produce recommendations that are practical and valuable to clinical practice.
“We acknowledge that there is still a large amount of research required to optimize the use of imaging tools in routine clinical practice, in particular which joints should be used for disease assessment.”
Disclosure: See the study for a full list of relevant disclosures.