Musculoskeletal CT, MRI, ultrasound, DXA and nuclear imaging
Which advanced test answers which rheumatology question. MRI sequences and sacroiliitis, ultrasound for synovitis, crystals and the GCA halo, dual-energy CT for urate, CT for bone detail, bone scan and FDG-PET, DXA in glucocorticoid users, with sample reports read step by step.
Tier 1Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Plain X-ray is still the first test for most joint problems (musculoskeletal X-ray). Advanced imaging answers a narrower question: is there active inflammation, crystal, infection or a hidden fracture?
- MRI sees marrow oedema, synovitis, enthesitis, cartilage, muscle and soft tissue. It is the test for axial spondyloarthritis, osteomyelitis, avascular necrosis and occult fracture.
- Ultrasound sees synovitis, tenosynovitis, enthesitis, erosions, crystal deposits and the GCA halo, at the bedside without radiation, and guides needles.
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Sources
- Mandl P et al. 2023 EULAR recommendations on imaging in diagnosis and management of crystal-induced arthropathies in clinical practice. Ann Rheum Dis 2024;83:752-9EULAR, 2023 (published 2024; latest when checked November 2026)
- Dejaco C et al. EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice: 2023 update. Ann Rheum Dis 2024;83:741-51EULAR, 2023 update (latest when checked November 2026)
- Schäfer VS et al. Ultrasound cut-off values for intima-media thickness of temporal, facial and axillary arteries in giant cell arteritis. Rheumatology (Oxford) 2017;56:1479-83Rheumatology (Oxford), 2017
- Mandl P et al. EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice. Ann Rheum Dis 2015;74:1327-39EULAR, 2015 (no EULAR update found November 2026)
- Diekhoff T et al. Reporting sacroiliac joint imaging performed for known or suspected axial spondyloarthritis: ASAS recommendations. Radiology 2024;311:e231786Assessment of SpondyloArthritis international Society, 2024
- Costantino F et al. EULAR recommendations for the reporting of ultrasound studies in rheumatic and musculoskeletal diseases. Ann Rheum Dis 2021;80:840-7EULAR, 2021
- Dejaco C et al. EULAR points to consider for the use of imaging to guide interventional procedures in patients with rheumatic and musculoskeletal diseases. Ann Rheum Dis 2022;81:760-7EULAR, 2022
- ACR Appropriateness Criteria: Chronic Extremity Joint Pain, Suspected Inflammatory Arthritis, Crystalline Arthritis, or Erosive Osteoarthritis: 2022 Update. J Am Coll Radiol 2023American College of Radiology, 2022 update (current November 2026)
- ACR Appropriateness Criteria: Suspected Osteomyelitis, Septic Arthritis, or Soft Tissue Infection (Excluding Spine and Diabetic Foot): 2022 Update. J Am Coll Radiol 2022American College of Radiology, 2022 update
- DXA reporting updates: 2023 Official Positions of the International Society for Clinical Densitometry. J Clin Densitom 2024;27:101437International Society for Clinical Densitometry, 2023 (latest adult positions, checked November 2026)
- Medicare Benefits Schedule, diagnostic imaging services (MRI, CT, ultrasound, nuclear medicine, bone densitometry)AU/NZAustralian Government Department of Health, Disability and Ageing
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy