Advances in imaging technologies for the assessment of peripheral neuropathies in rheumatoid arthritis

Rheumatol Int. 2021 Mar;41(3):519-528. doi: 10.1007/s00296-020-04780-5. Epub 2021 Jan 11.

Abstract

Peripheral neuropathy in patients with rheumatoid arthritis is associated with a maladaptive autoimmune response that may cause chronic pain and disability. Nerve conduction studies are the routine method performed when rheumatologists presume its presence. However, this approach is invasive, may not reveal subtle malfunctions in the early stages of the disease, and does not expose abnormalities in structures surrounding the nerves and muscles, limiting the possibility of a timely diagnosis. This work aims to present a narrative review of new technologies for the clinical assessment of peripheral neuropathy in Rheumatoid Arthritis. Through a bibliographic search carried out in five repositories, from 1990 to 2020, we identified three technologies that could detect peripheral nerve lesions and perform quantitative evaluations: (1) magnetic resonance neurography, (2) functional magnetic resonance imaging, and (3) high-resolution ultrasonography of peripheral nerves. We found these tools can overcome the main constraints imposed by the previous electrophysiologic methods, enabling early diagnosis.

Keywords: Functional MRI; MR neurography; Neuropathies; Peripheral nervous system diseases; Rheumatic diseases; Ultrasonography.

Publication types

  • Review

MeSH terms

  • Arthritis, Rheumatoid / complications*
  • Arthritis, Rheumatoid / diagnostic imaging
  • Arthritis, Rheumatoid / pathology
  • Humans
  • Magnetic Resonance Imaging / adverse effects
  • Magnetic Resonance Imaging / methods
  • Peripheral Nervous System Diseases / diagnostic imaging*
  • Peripheral Nervous System Diseases / etiology
  • Peripheral Nervous System Diseases / pathology
  • Ultrasonography / adverse effects
  • Ultrasonography / methods