Reachout Orthopedics - Issue 2

Fausto Salaffi 1 , Marina Carotti 2 , Giacomo Beci 1 , Marco Di Carlo 1 , Andrea Giovagnoni 2 (  ) Marco Di Carlo (  ) dica.marco@yahoo.it Fausto Salaffi fausto.salaffi@gmail.com Marina Carotti marina.carotti@gmail.com Giacomo Beci giacomo.beci@gmail.com Andrea Giovagnoni a.giovagnoni@univpm.it 1  Rheumatological Clinic, Ospedale “Carlo Urbani”, Università Politecnica delle Marche, Via Aldo Moro, 25, 60035 Jesi, Ancona, Italy 2  Radiology Department, Università Politecnica delle Marche, Ancona, Italy Structural changes of bone and cartilage are the hallmarks of rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Radiography can help in making diagnosis and in differentiating PsA and RA from other articular diseases. Radiography is still considered the preferred imaging method to assess disease progression, reflecting cumulative damage over time. This review discusses the use of conventional radiography for diagnosing and detecting early structural changes in RA and PsA and providing a historical overview of commonly used scoring methods. R heumatoid arthritis (RA) and psoriatic arthritis (PsA) are the most prevalent inflammatory arthritis leading to structural damage, affecting about 0.46% and 0.42%, respectively, of the population in Western countries [1, 2]. Since its introduction in clinical practice, radiographs of the hands and feet have been used to diagnose and to monitor the disease course of RA and PsA [3–5]. The presence of radiographic bone erosions is fundamental for RA classification, according also to the more recent classification criteria (American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) 2010 classification criteria) [6], while for PsA, in the Classification Criteria for Psoriatic Arthritis (CASPAR), radiography still remains one of the main criteria for classifying PsA [7]. Assessing radiographic abnormalities is one of the most powerful means available to the clinical investigator for determining the effects of RA and has been used as a relatively objective marker in clinical trials for evaluating treatment response [8].The efficacy of disease-modifying antirheumatic drugs (DMARDs) traditionally has been registered as their ability to slow down radiographic damage [9]. These points are outlined in EULAR recommendations and models for management of early arthritis, and prognostic markers for persistent arthritis have been established [10]. Therefore, the current “gold standard” for radiological evaluation of disease progression in RA is the assessment of disease progression with plain radiographs. Many researches have shown that in RA, joint damage occurs within the first 2 years after symptom appearance [11–14]. It has RADIOGRAPHIC SCORING METHODS IN RHEUMATOID ARTHRITIS AND PSORIATIC ARTHRITIS 2 Views and Reviews