La radiologia medica

, Volume 124, Issue 11, pp 1167–1174 | Cite as

Diagnostic imaging: pitfalls in rheumatology

  • Marcello Zappia
  • Nicola Maggialetti
  • Raffaele NatellaEmail author
  • Alfonso Reginelli
  • Federico Bruno
  • Francesco Di Pietto
  • Luca Brunese


Although the diagnosis of arthritis and spondyloarthritis is based on clinical criteria, today the imaging methods are an indispensable aid to the rheumatologist. Imaging has not only the task of helping early diagnosis, but it has also a fundamental role in disease grading and therapeutic monitoring. In this scenario where many publications emphasize the importance of identifying synovitis and erosions at an early stage, it is essential to know the possible pitfalls which can determine both false positives and false negatives. The high variability of the musculoskeletal system anatomy makes it necessary to have a correct knowledge of all anatomical complexes, in order not to confuse them with the pathology. Moreover, the correct and standardized method of the execution and interpretation of the exams, such as ultrasound, is crucial to identifying and correctly monitoring the pathological hallmarks of the arthritis. This paper aims to provide an instrument to radiologists, highlighting the main imaging pitfalls in ultrasound and magnetic resonance which may be encountered in daily practice.


MRI Arthritis Ultrasound Enthesitis Pitfalls 


Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study formal consent is not required.


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Copyright information

© Italian Society of Medical Radiology 2019

Authors and Affiliations

  1. 1.Department of Medicine and Health SciencesUniversity of MoliseCampobassoItaly
  2. 2.Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale F Magrassi e A LanzaraUniversita degli studi della Campania Luigi VanvitelliNaplesItaly
  3. 3.Department of Precision MedicineUniversity of Campania “Luigi Vanvitelli”NaplesItaly
  4. 4.Department of Biotechnology and Applied Clinical Sciences, S. Salvatore HospitalUniversity of L’AquilaL’AquilaItaly
  5. 5.Department of RadiologyPineta Grande HospitalCastel VolturnoItaly

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