EULAR has released the first evidence-based recommendations that go beyond gout to cover the use of imaging in the clinical management of other common crystal-induced arthropathies (CiAs).
Published in the Annals of the Rheumatic Diseases (link here), the guidance comprises five overarching principles and 10 recommendations on the role of imaging modalities such as conventional radiography, ultrasound, CT and MRI. The CiA assessed included gout, calcium pyrophosphate deposition disease and basic calcium phosphate deposition disease.
The EULAR international task force comprised rheumatologists such as Professor Nicola Dalbeth of Auckland University, as well as radiologists, and other healthcare professionals. They address the role of imaging in various aspects of patient management: making a diagnosis of CiA, monitoring inflammation and damage, predicting outcome, response to treatment, guided interventions and patient education.
The principles state that CiA can be characterised by intermittent, acute episodes of inflammation – but they can also follow a chronic disease course with or without flares.
They include the caveat that while imaging provides useful information on crystal deposition, inflammation, and structural damage, abnormalities on imaging may not be related to clinical symptoms, and patient information including medical history, laboratory results, and physical examination are always the most relevant to be taken into account.