Rheumatoid Arthritis

  • Yong-Whee BahkEmail author


Rheumatoid arthritis is a fairly common systemic disease of multifarious and obscure etiologies, affecting primarily the synovial membranes of the joints in the appendicular and axial skeleton. It has a notorious predilection for the small joints of the hands and feet although the large joints of the wrists, knees, elbows, shoulders, and sternum are not exempted. The involvement is typically polyarticular and symmetrical. In the spine, the cervical vertebrae, particularly the atlantoaxial joint, are most commonly involved, and cervical involvement may or may not be accompanied by appendicular arthritis (Bland (1967) Rheumatoid arthritis of the cervical spine. Bull Rheum Dis 18:471–476). The prevalence rate estimated using the 1958 criteria of the American Rheumatism Association for definite rheumatoid arthritis varies from 0.3% to 1.5% (Wolfe (1968) The epidemiology of rheumatoid arthritis: review. Bull Rheum Dis 19:518–523), and limited population studies performed in Europe and North America have indicated the incidence to range from 1% to 3%. A recent limited population study performed in Seoul has shown a prevalence rate of 1.5% (Bae SC (2005), personal communication). Women are affected two to three times more frequently than men. Adults in any age may be affected, with the highest incidence occurring between the fifth and sixth decades of life.


  1. Ansell BM, Kent PA (1977) Radiological changes in juvenile chronic arthritis. Skeletal Radiol 1:129–144Google Scholar
  2. Arnett FC, Edworthy SM, Bloch DA et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324Google Scholar
  3. Babini JC, Gusis SS, Babini SM et al (1992) Superolateral erosions of the humeral head in chronic inflammatory arthropathies. Skeletal Radiol 21:515–517Google Scholar
  4. Bae SC (2005), personal communicationGoogle Scholar
  5. Beckers C, Ribbens C, Andre B et al (2004) Assessment of disease activity in rheumatoid arthritis with 18F-FDG PET. J Nucl Med 45:956–964Google Scholar
  6. Bland JH (1967) Rheumatoid arthritis of the cervical spine. Bull Rheum Dis 18:471–476Google Scholar
  7. Calabro JJ (1962) A critical evaluation of the diagnostic features of the feet in rheumatoid arthritis. Arthritis Rheum 5:19–29Google Scholar
  8. Cotran RS, Kuman V, Robbins SL (1989) Inflammation and repair. In: Cotran RS, Kuman V, Robbins SL (eds) Pathologic basis of disease. WB Saunders, Philadelphia, pp 39–86Google Scholar
  9. Dalm VA, van Hagen PM, Krenning EP (2003) The role of octreotide scintigraphy in rheumatoid arthritis and sarcoidosis. Q J Nucl Med 47:270–278Google Scholar
  10. de Bois MH, Pawels EK, Breedvelt FC (1995) New agents for scintigraphy in rheumatoid arthritis. Eur J Nucl Med 22:1339–1346Google Scholar
  11. Elhabali M, Sherak O, Seidl G et al (1979) Tomographic examinations of sacroiliac joints in adult patients with rheumatoid arthritis. J Rheumatol 6:417–425Google Scholar
  12. Feldmann M, Brennan FM, Chantry D et al (1990) Cytokine production in the rheumatoid joint: implications for treatment. Ann Rheum Dis 49:480–486Google Scholar
  13. Fletcher DE, Rowley KA (1952) The radiological features of rheumatoid arthritis. Br J Radiol 25:282–295Google Scholar
  14. Foster DR, Park WM, McGall IW, Ward DJ (1980) The supinator notch sign in rheumatoid arthritis. Clin Radiol 31:195–199Google Scholar
  15. Freyberg RH (1968) A study of time of onset of structural joint damage in rheumatoid arthritis (abstract). Arthritis Rheum 11:481Google Scholar
  16. Gibson HJ (1955) Special pathology of rheumatoid arthritis. In: Copeman WSC (ed) Textbook of the rheumatic disease, 2nd edn. Churchill Livingstone, LondonGoogle Scholar
  17. Gumina S, Salvatore M, De Santis R et al (2002) Coracoclavicular joint: osteolytic study of 1020 human clavicles. J Anat 201:513–519Google Scholar
  18. Hendrix RW, Urban MA, Schroeder JL, Rofer LF (1987) Carpal predominance in rheumatoid arthritis. Radiology 164:219–222Google Scholar
  19. Hopfner S, Treitl M, Krolak C et al (2002) Diagnosis of initial changes in the hand of patients with rheumatoid arthritis—comparison between low-field magnetic resonance imaging, 3-phase bone scintigraphy and conventional X-ray. Nuklearmedizin 41:135–142Google Scholar
  20. Hopfner S, Treitl M, Becker-Gaab C et al (2004) Diagnosis of initial changes in patients suffering from rheumatoid arthritis. Two years follow up control with a low-field magnetic resonance scanner, 3-phase bone scintigraphy and conventional X-ray. Nuklearmedizin 43:195–202Google Scholar
  21. Jamar F, Houssiau FA, Devogelaer et al. (2002) Scintigraphy using a technetium 99m-labeled anti-E-selectin Fab fragment in rheumatoid arthritis. Rheumatology (Oxford) 41:53–61Google Scholar
  22. Jones MM, Moore WH, Brewer EK et al (1988) Radionuclide bone/joint imaging in children with rheumatic complaints. Skeletal Radiol 17:1–7Google Scholar
  23. Lawrence JS, Sharp J, Ball J et al (1964) Rheumatoid arthritis of the lumbar spine. Ann Rheum Dis 23:205–217Google Scholar
  24. Lehtinen JT, Kaarela K, Belt EA et al (1999) Coracoclavicular involvement—an atypical manifestation in rheumatoid arthritis. Scand J Rheumatol 28:252–253Google Scholar
  25. Miller ML, Cassidy JT (2004) Juvenile rheumatoid arthritis. In: Behrman RE, Kliegman RM, Jenson HL (eds) Nelson textbook of pediatrics, 17th edn. WB Saunders, Philadelphia, pp 799–805Google Scholar
  26. Resnick D (1974) Rheumatoid arthritis of the wrist: why the ulnar styloid? Radiology 112:29–35Google Scholar
  27. Resnick D (1976) Early abnormalities of pisiform and triquetrum in rheumatoid arthritis. Ann Rheum Dis 35:46–50Google Scholar
  28. Resnick D (2004) Diagnosis of bone and joint disorders, 4th edn. WB Saunders, Philadelphia, PA, pp 891–987Google Scholar
  29. Rothschild BM, Masi AT (1982) Pathogenesis of rheumatoid arthritis: a vascular hypothesis. Semin Arthritis Rheum 12:11–31Google Scholar
  30. Sandrock D, Backhaus M, Burmesten G, Munx DL (2003) Imaging technology in rheumatology: scintigraphy in rheumatoid arthritis. Z Rheumatol 62:476–480Google Scholar
  31. Sims-Williams H, Jayson MIV, Baddeley H (1977) Rheumatoid involvement of the lumbar spine. Ann Rheum Dis 36:524–531Google Scholar
  32. Stevens CR, Blake DR, Merry P et al (1991) A comparison study by morphometry of microcirculation in normal and rheumatoid synovium. Arthritis Rheum 34:1508–1513Google Scholar
  33. Vaudo G, Marchesi S, Gerli R et al (2004) Endothelial dysfunction in young patients with rheumatoid arthritis and low disease activity. Ann Rheum Dis 63:31–35Google Scholar
  34. Wolfe AM (1968) The epidemiology of rheumatoid arthritis: review. Bull Rheum Dis 19:518–523Google Scholar
  35. Yasuda S, Shotsu A, Ide M et al (1996) F-18 FDG accumulation in inflamed joints. Clin Nucl Med 21:740Google Scholar
  36. Zikou AK, Alamanos Y, Argyropoulou MI et al (2005) Radiological cervical spine involvement in patients with rheumatoid arthritis: a cross sectional study. J Rheumatol 32:801–806PubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2017

Authors and Affiliations

  1. 1.Department of Nuclear Medicine and RadiologySun Ae General HospitalSeoulSouth Korea

Personalised recommendations