Inflammatory arthritis is a collection of autoimmune diseases that primarily attack the joints. X-ray is commonly used as a diagnostic tool and way to gauge the progression of the disease. Unfortunately, x-ray does not tell the entire story and more sophisticated imaging might explain pain and limitations that do not show up on x-ray.

Joint Degeneration

X-ray can show some joint erosion and narrowing of the joint space. Any erosion may need to be advanced before they are easily observed on x-ray. Joint space narrowing occurs when the cartilage that cushions the joint deteriorates, but the cartilage itself does not show up on x-ray. MRI may show joint erosion when they are in the earlier stages and could be missed by x-ray. Similarly, MRI might show degeneration of the cartilage in affected joints before it become obvious the joint space is narrowing. These subtle changes in joints may cause your rheumatologist to change your treatment plan or they may want consistent imaging tests to see how quickly the disease is progressing.

Swelling

Swelling may need to be dramatic before it can be seen by other people, but patients often notice subtle swelling because it may limit range of motion or become painful. MRI is better able to detect soft tissue swelling, even if it is not apparent during manual joint examinations. More sensitive imaging can differentiate between swelling that is a result of the inflammatory processes associated with your condition or other types of swelling. For example, sometimes fluid can collect and create large cysts that may eventually become infected. This will appear as a large, dark area, and will need to be treated differently than swelling associated with your arthritis. The development of large fluid-filled cysts, which is common with inflammatory arthritis, means the area needs to be drained to prevent infections from developing.

Soft Tissue Damage

An often overlooked aspect of inflammatory arthritis is the effect swelling and inflammation has on the surrounding soft tissues. Some soft tissues help attach muscle to bone or bone to bone, whereas others provide cushion to prevent ligaments or tendons from rubbing against the bones. Just as the immune system attacks the joints, it can attack the soft tissues, causing damage, pain, and instability of the affected joint. MRI can be used to visualize damage that might weaken tendons or ligaments and lead to tendon ruptures or joint dislocations. When the soft tissues become extensively damaged, surgery may be necessary to repair tendons or ligaments.

MRI is infrequently used in the diagnosis and management of inflammatory arthritis, but it has significant benefits over x-ray. Detecting damage in the earlier stages can prevent failures of joints and the need for future joint repairs. Contact a provider, such as Kenai Peninsula Imaging Center, LLC, for more help.