Newer techniques of iodine-DECT mapping and high-resolution peripheral quantitative CT have shown promise in detection and quantification of periarticular/tenosynovial inflammation and bony changes, respectively [15]. Further validation is needed; however, and these techniques are not widely used in clinical practice. CT Area of Interest Without IV Contrast There is insufficient evidence to support the routine use of CT area of interest without IV contrast for the evaluation of seropositive or seronegative inflammatory arthritis in the extremities following initial radiographs. As mentioned before, although CT can show bony erosions and productive changes with high diagnostic confidence, the ability of CT to identify and characterize associated inflammatory soft tissue findings and bone marrow edema is limited. Chronic Extremity Joint Pain FDG-PET/CT Whole Body FDG-PET uptake can be seen at sites of inflammation but is limited by being nonspecific [14,16]. Novel PET tracers targeting specific immunological targets in RA have been described but only tested preclinically or in small patient cohorts [17]. Further research is needed to validate these early results and determine their clinical role, if any. The literature suggests that PET/CT studies are not routinely obtained for evaluation of seropositive or seronegative inflammatory arthritis in the extremities following initial radiographs. Image-Guided Aspiration Area of Interest Image-guided aspiration is generally not useful in the seropositive or seronegative inflammatory arthritis in the extremities following initial radiographs. Image-guided aspiration may be helpful in excluding crystal deposition disease and infection.
Chronic Extremity Joint Pain Suspected Inflammatory Arthritis Crystalline Arthritis or Erosive Osteoarthritis PCAs. Newer techniques of iodine-DECT mapping and high-resolution peripheral quantitative CT have shown promise in detection and quantification of periarticular/tenosynovial inflammation and bony changes, respectively [15]. Further validation is needed; however, and these techniques are not widely used in clinical practice. CT Area of Interest Without IV Contrast There is insufficient evidence to support the routine use of CT area of interest without IV contrast for the evaluation of seropositive or seronegative inflammatory arthritis in the extremities following initial radiographs. As mentioned before, although CT can show bony erosions and productive changes with high diagnostic confidence, the ability of CT to identify and characterize associated inflammatory soft tissue findings and bone marrow edema is limited. Chronic Extremity Joint Pain FDG-PET/CT Whole Body FDG-PET uptake can be seen at sites of inflammation but is limited by being nonspecific [14,16]. Novel PET tracers targeting specific immunological targets in RA have been described but only tested preclinically or in small patient cohorts [17]. Further research is needed to validate these early results and determine their clinical role, if any. The literature suggests that PET/CT studies are not routinely obtained for evaluation of seropositive or seronegative inflammatory arthritis in the extremities following initial radiographs. Image-Guided Aspiration Area of Interest Image-guided aspiration is generally not useful in the seropositive or seronegative inflammatory arthritis in the extremities following initial radiographs. Image-guided aspiration may be helpful in excluding crystal deposition disease and infection.