X-ray is frequently used in the early stages of inflammatory arthritis as a diagnostic tool and in the latter stages to view the progression of joint damage. Although x-rays are inexpensive and can show certain types of damage, they are not always the best option. 

Better Diagnostic Tool

Since there are several forms of arthritis, it can be difficult to differentiate between them if you do not have a textbook presentation. For example, rheumatoid arthritis (RA) is considered a seropositive form of inflammatory arthritis. This means it is a type of inflammatory arthritis associated with positive blood tests, such as the anti-cyclic citrullinated peptides (anti-CCP) and rheumatoid factor (RF).

However, not all cases of RA are seropositive. A significant percentage of people with RA are seronegative. If you have symptoms that resemble RA, an MRI is capable of identifying soft tissue damage that is not visible on x-ray. This may lead your doctor to come to a definitive diagnosis earlier in the course of the disease.

Identifying Early Joint Damage

X-ray is the first-line imaging test for any form of arthritis, however, it does not tell the entire story. Many types of damage associated with different forms of inflammatory arthritis are not visible on x-ray until there has been extensive damage. It may take years of continuous inflammation before bone erosions are visible on x-ray.

Inflammatory arthritis can also cause regional bone demineralization (osteopenia), which cannot be observed on x-ray until significant demineralization has occurred. Earlier identification of damage can make a difference in your treatment plan. Your doctor may choose to try different medications sooner or act more aggressively in your treatment if it is obvious you have suffered irreversible damage.

Uncovering Soft Tissue Damage

Damage that occurs to the soft tissues cannot be observed on x-ray. The constant inflammation and swelling that is often seen in inflammatory arthritis not only causes joint damage but in many cases it creates deformities. These deformities occur because supporting structures, such as ligaments and tendons can rupture.

Although identifying damage to soft tissues early may not help prevent deformities, it may help the course of treatment and encourage non-surgical techniques to help support joint instability. Once a deformity has been present for several months, the only treatment is to fuse the joint, which causes loss of mobility in the joint.

MRI is a useful tool for the diagnosis and management of inflammatory arthritis. When possible, consider asking a doctor (such as one from Surgery Center of Kenai) if an MRI could offer better visualization of changes from inflammatory arthritis.