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Arthritis und Rheuma 2020; 40(03): 153-162
DOI: 10.1055/a-1162-2541
DOI: 10.1055/a-1162-2541
Schwerpunkt
Röntgendiagnostik in der Rheumatologie im Jahr 2020
Radiography in the field of Rheumatology in 2020Further Information
Publication History
Publication Date:
16 June 2020 (online)
ZUSAMMENFASSUNG
In der Diagnostik von rheumatologischen Erkrankungen im Bereich der peripheren Gelenke und des Achsenskelettes stellt das Röntgenbild weiterhin die primäre bildgebende Diagnostik aufgrund der ubiquitären Verfügbarkeit als auch der standardisierten Durchführbarkeit dar. Die Röntgendiagnostik wird insbesondere zur Beurteilung der Manifestation einer rheumatologischen Erkrankung am Achsenskelett und an den peripheren Gelenken, zur Verifizierung des radiologischen Schweregrades und zur Quantifizierung der radiologischen Progression bei Patienten mit einer rheumatoiden Arthritis, Psoriasisarthritis, Arthrose und Osteoporose eingesetzt. Die Beurteilung des radiologischen Schweregrades ist über verschiedene Scoring-Modelle möglich, wobei die krankheitsspezifischen Scores vor allem in klinischen Studien eingesetzt werden und in der klinischen Routine kaum Beachtung finden. Eine Aussage in Bezug auf Weichteilstrukturen bzw. zu intraossären entzündlichen Veränderungen ist durch die Röntgendiagnostik nur in einem sehr begrenzten Umfang möglich, sodass hier auf additive bildgebende Verfahren, beispielsweise die Magnetresonanztomografie zurückgegriffen werden muss.
ABSTRACT
The diagnostic imaging of rheumatic diseases is still primary based on radiographs due to its advanced availability and its standardized acquisition. Radiographs were used to evaluate the manifestation of rheumatic disease regarding axial skeleton and peripheral joints, the radiographic severity and radiological progression in patients suffering from rheumatoid arthritis, psoriatic arthritis, osteoarthritis and osteoporosis. Different scoring models were used to quantify radiographic severity, whereas the scores were preferential used in clinical studies and play only a limited role in the clinical practice. Additionally, the evaluation of soft tissue and intraosseous inflammatory alterations is restricted by radiographs. In this context, additionally imaging for example magnetic resonance imaging is recommended for the further detailed evaluation.
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