Author(s): Ahmad HS, Kombar O, Shady I, Shaat RM, Othman G

Rheumatoid arthritis (RA) is traditionally considered as the prototype of destructive arthritis. Joint destruction in RA often begins very early and progresses rapidly within the first years from symptoms onset. Studies on very early RA (≤ 3 months from symptom onset) have shown that up to 20% of the patients already present with erosions at baseline. Preventing joint damage is the ultimate aim of current and novel therapies and treatment strategies in RA. Therefore, distinguishing which patient with early RA is to run a severe disease course with development of erosions and which is not at baseline evaluation is a major challenge in the management of RA. Conventional radiography remains the mainstay for evaluation of RA patients. Although bony erosions and subluxations can be demonstrated in advanced disease, yet in the early stages of the disease there may be no changes, or may demonstrate non-specific changes.

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