Whole-body MRI in arthritis.

Abstract

Whole-body MRI (wbMRI) is an advanced scan modality which provides high-contrast resolution images of the entire body for screening, diagnosis, staging, and surveillance purposes. Thanks to recent technological advancements, wbMRI has gained increasing attention as a valuable tool for diagnosing and monitoring systemic arthritides by virtue of its comprehensive coverage. This technology is particularly beneficial for inflammatory conditions like rheumatoid arthritis, seronegative spondyloarthropathy, juvenile idiopathic arthritis, and chronic aseptic osteitis, all characterized by multifocal involvement of both skeletal and extra-skeletal sites. Unlike conventional MRI targeting symptomatic areas, wbMRI enables concurrent early detection also of subclinical disease foci, providing a more accurate assessment of the total disease burden. Compared to plain radiography, conventional ultrasound, and targeted MRI, wbMRI offers better sensitivity and reproducibility, particularly for intraosseous findings and axial involvement. In addition, wbMRI can be tailored to specific clinical needs through customizable scan protocols, and the lack of ionizing radiation makes it ideal for monitoring autoimmune diseases also in sensitive cohorts. Although wbMRI holds great potential for improving diagnostic accuracy and patient outcomes in inflammatory arthritis, further research is needed to validate standard scan protocols, to confirm their cost-effectiveness, and to integrate them into routine clinical practice. The present article aims to overview the current wbMRI technology and discuss it in the context of inflammatory arthritis. A general wbMRI protocol for non-oncologic musculoskeletal application is also provided.