Erwartungen des Rheumatologen an die Bildgebung

CLINICAL/METHODICAL ISSUE: Clinical examination and laboratory results are often insufficient to support therapeutic decisions. STANDARD RADIOLOGICAL METHODS: Diagnosis and organ-related imaging may provide important additional information for initial diagnosis (differential diagnoses), follow-up and prognosis. Especially functional imaging techniques, such as ultrasound and magnetic resonance imaging are becoming more and more important for early diagnosis. METHODICAL INNOVATIONS: Imaging is already recognized in the classification criteria of several rheumatic diseases and new criteria for spondyloarthritis and polymyalgia rheumatica aim more and more at early diagnosis using functional imaging techniques, such as ultrasound and magnetic resonance imaging. PERFORMANCE: Specific imaging findings are helpful for eliminating differential diagnoses. During follow-up disease control the status as well as progression of structural damage can be documented. In selected diseases imaging allows prognostic statements on both disease progression and therapeutic response to specific medication. ACHIEVEMENTS: The evidential value of imaging results varies with the rheumatological expectations. PRACTICAL RECOMMENDATIONS: Overall rheumatological expectations on imaging differ widely and therefore support a differentiated use of imaging techniques.