Question
I am a 45 year old female who was diagnosed with RA 8 years ago. My rheumatologist has never ordered x-rays and I am becoming concerned since my elbow and ring finger have sustained permanent deformities. Fluid was removed from my knee this year and I still have some residual swelling. I have an appointment with my rheumatologist in a few weeks and I’m not sure if it would be appropiate for me to ask for x-rays. I have been on plaquenil since the RA was diagnosed and prednisone for 1 1/2 years after the onset and this year for several months. I am becoming very concerned about joint erosion. Can the baselining to determine erosion be accomplished through the physical exam and laboratory tests alone? When do rheumatologists utilize x-rays.
Answer
This is a good topic to discuss with your rheumatologist. Over the past several years, there has been increased emphasis on the prevention of joint damage particularly since we have new agents, the TNF inhibitors which have been shown to be very effective in preventing damage. Thus x-rays have become a more important tool in assessing disease activity and disease progression.
