Clinically suspect arthralgia and early rheumatoid arthritis: advances in imaging and impact on daily life

Abstract

A large part of this thesis focussed on the additional value of MRI in the early detection

of RA. In contrast to showing its additional value, we also found that MRI can also

be too sensitive and appoint patients with MRI-detected inflammation that never will go on to develop imminent, chronic RA. In clinical practise the exact role of imaging for the early detection of RA still needs to be established further. Also the causes of inflammation at MRI in patients with CSA or early IA are not fully understood yet. It needs to be specified in which individual patients, MRI has the most beneficial effects and in combination with which clinical characteristics. In addition to this, also its cost effectiveness needs to be determined. The second part of this thesis focused more on subjective components of the disease, which is highly valuable for patients’ themselves. But next to this, a patients’ perspective is increasingly being taken into account for decisions on treatment options. Although current treatment strategies have resulted in improved disease outcomes and chronic damage can be prevented in a large amount of patients, patients still experience problems in daily life and at work. As we observed that despite improved therapies, many important outcomes remain present, like fatigue and pain, these should also be incorporated in future treatment aims as they pose a burden on patients’ wellbeing as well as on society.