Rheumatoid Arthritis Imaging Tests

Rheumatoid arthritis imaging tests are used to look for signs of rheumatoid arthritis and to monitor the disease’s progression. These tests primarily look for bone damage in the patient’s joints caused by rheumatoid arthritis symptoms.

X-rays used to be the most common form of imaging scan but weren’t always great for reaching an early diagnosis. Today’s technology provides much more advanced imaging techniques including MRIs and ultrasounds, which allow doctors to better find early signs of rheumatoid arthritis.

All types of imaging tests are a critical component of diagnosing rheumatoid arthritis and monitoring the patient’s condition over time. Imaging tests provide doctors with a clear picture of the patient’s progression so that they can pursue appropriate treatment options.

What are Rheumatoid Arthritis Imaging Tests?

Imaging tests are tests that are done on patients to help identify signs and progression of rheumatoid arthritis. These tests essentially look inside the patient’s body so that doctors and other specialists may assess the test results and detect and interpret specific abnormalities.

Depending on what they find, doctors can use imaging test results to help reach a diagnosis of rheumatoid arthritis.

What do Imaging Tests Look for?

Rheumatoid arthritis imaging tests look for signs of bone erosion, inflammation and swelling, tissue damage and overall joint deterioration in  patients. They are used for the detection of rheumatoid arthritis symptoms and in monitoring the progression of the disease over time.

Imaging tests can show where the patterns of deterioration are beginning to form around the joints. Bone erosion is a very serious concern in rheumatoid arthritis patients and can be irreversible. Imaging tests identify this early on so that targeted treatment can begin and prevent further damage to the patient.

If imaging tests do not find any specific or conclusive signs of bone deterioration, it doesn’t entirely rule out a rheumatoid arthritis diagnosis. It could mean instead that the disease is in its early stages and hasn’t yet produced any bone damage.

Imaging tests ultimately provide an opportunity to treat rheumatoid arthritis symptoms as soon as possible. Treatment is far more effective in reducing pain, stiffness, swelling and bone erosion when symptoms are caught early on.

Types of Imaging Tests

There are three main types of rheumatoid arthritis imaging tests used in diagnosing and monitoring disease. These rheuamtoid arthritis imaging tests are:

  • X-Rays
  • Magnetic Resonance Imaging (MRIs)
  • Ultrasounds

Doctors may use one or a combination of all of these imaging tests to help reach a rheumatoid arthritis diagnosis and continue to monitor progression.


X-rays are radiographic imaging tests that allow doctors to find locations in their patients where bone erosion is occurring at the joints. X-rays show doctors where the erosion is occurring and how badly it is progressing. This type of progression detection happens when multiple x-rays are taken over time.

X-rays are the standard imaging test doctors use to assess joint destruction in rheumatoid arthritis patients. Though x-rays are a preferred method of imaging test, their visual results aren’t great at detecting the earliest signs of rheumatoid arthritis. This is because their visual results only reveal damage after it has been done, which means the symptoms have progressed to the point of causing noticeable damage.


The MRI test is a more advanced imaging technique which involves a detailed look into the patient’s body.  Whereas X-rays look at bone, MRIs detect abnormalities beyond the patient’s bones.

MRIs are better at detecting early signs of rheumatoid arthritis as compared to X-rays. MRIs can reveal the signs that aren’t related directly to the bone such as joint tissue inflammation. MRIs can also detect issues with the tendons ligaments.

One early sign of bone deterioration is the build-up of fluid in the bone marrow. MRIs are able to detect these areas with greater fluid build-up, which helps in predicting future bone erosion.


Ultrasounds are a newer technique used in rheumatoid arthritis diagnostics and monitoring. This form of imaging test uses high-frequency sound waves to take pictures of the inside of the patient’s body. Unlike x-rays, ultrasounds do not emit radiation.

Like MRIs, ultrasounds are better at detecting early signs of erosion caused by rheumatoid arthritis compared to x-rays. Ultrasound results can reveal areas of joint inflammation, which can help support a rheumatoid arthritis diagnosis.

The ultrasound test’s ability to detect inflammation levels is also important in detecting disease progression. Rheumatoid arthritis patients can sometimes show signs of remission. This means that patients and their doctors may decide to reduce or stop treatment. But if ultrasound tests reveal that there is still inflammation present despite signs of remission, then the doctor knows to continue treatment.

The use of ultrasounds in monitoring joint deterioration in rheumatoid arthritis patients is becoming more common. However, x-rays remain the primary standard that doctors use for monitoring rheumatoid arthritis disease progression.

How Imaging Tests Help Diagnose Rheumatoid Arthritis

None of the imaging tests on their own can produce results sufficient enough to diagnose rheumatoid arthritis. Imaging tests combined with the assessment of physical symptoms, blood tests, and medical history are all used in combination with each other to reach a rheumatoid arthritis diagnosis.

Tests are helpful tools in reaching a diagnosis and providing a clear medical picture of the patient’s present condition. Imaging tests are also used post-diagnosis in order to continue to monitor the patient’s levels of bone erosion. Imaging tests can indicate the severity of the disease’s progression in each patient.

Imaging Testing Used in Rheumatoid Arthritis Prognosis

All three imaging tests can be used to monitor progression over the disease course. However, it is difficult for doctors to deliver a firm prognosis for rheumatoid arthritis as the disease manifests itself differently in each patient.

Beyond using x-rays and other rheumatoid arthritis imaging tests to assess bone erosion levels, doctors cannot conclusively determine if deterioration will worsen or slow down other than what the image tests reveal at the time.