Conditions we diagnose and treat

Rheumatoid Arthritis Imaging in London

Available at LSRI Harley Street (W1G 9QJ) and LSRI Northwest London, Harrow (HA2 7SJ).

Rheumatoid arthritis is a long-term autoimmune condition in which the immune system attacks the lining of the joints (the synovium), causing inflammation, pain and swelling.

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GMC / FRCR Dr Prashant Sankaye, Consultant MSK Radiologist

It most often affects the small joints of the hands and feet, usually on both sides of the body, and can start at any age, although it most commonly begins in middle age and is more common in women. Early diagnosis and treatment by a rheumatologist can help protect the joints. At LSRI, Dr Prashant Sankaye, Consultant MSK Radiologist, provides ultrasound, MRI and X-ray imaging to support diagnosis and monitoring, working alongside your rheumatologist. The “Rheumatology” in our name, London Sports and Rheumatology Imaging, refers to this imaging service for rheumatology patients.

Why choose LSRI

Consultant-led care from Dr Prashant Sankaye, Consultant MSK Radiologist with more than 20 years’ experience.
Diagnosis and ultrasound-guided treatment from the same specialist.
Two clinics: LSRI Harley Street (W1G 9QJ) and LSRI Northwest London in Harrow (HA2 7SJ).
No GP referral needed, and all major insurers accepted.
After Dr Sankaye has reported your scan, you can have a free 5-minute video consultation to go through the results.

Last medically reviewed by Dr Prashant Sankaye, Consultant MSK Radiologist, on 2 October 2026.

Symptoms of rheumatoid arthritis

Pain, swelling and warmth in several joints, often the small joints of the hands, wrists and feet.
Stiffness in the morning that takes a long time to ease.
Joints affected on both sides of the body.
Tiredness, feeling generally unwell or a mild temperature.
Difficulty gripping, making a fist or walking comfortably.

If you have persistent joint swelling without a clear cause, particularly in the small joints of the hands or feet or in more than one joint, see your GP promptly. People with suspected early inflammatory arthritis should be referred urgently to a rheumatologist, even if blood tests are normal. A single hot, swollen joint with fever needs urgent same-day medical advice, as it may be a sign of infection.

How we diagnose rheumatoid arthritis

Rheumatoid arthritis is diagnosed by a rheumatologist, using your symptoms, an examination, blood tests and imaging. Imaging can add valuable information, particularly early on.

Ultrasound, including Doppler to show blood flow, can detect active inflammation in the joint lining (synovitis) and around tendons, even when a joint does not look obviously swollen. It can also show small areas of bone damage (erosions) earlier than X-ray. This can help your rheumatologist confirm inflammation and judge how active the disease is.

MRI can also show synovitis and erosions earlier than X-ray, as well as inflammation within the bone, and can be helpful when the diagnosis is uncertain.

An X-ray of the hands and feet is often used at diagnosis as a baseline, so that any joint damage can be tracked over time.

Imaging also helps tell rheumatoid arthritis apart from other causes of joint pain. You can read more in our articles on osteoarthritis vs rheumatoid arthritis and the role of rheumatology imaging in managing chronic joint pain.

What to expect at your appointment

Dr Sankaye reviews your symptoms, blood test results, current treatment and any previous scans.
He scans the affected joints with ultrasound, including Doppler, and arranges an X-ray or MRI if needed.
He explains the findings and discusses the next steps, including liaison with your rheumatologist.
If you and your rheumatologist decide on an injection for a flaring joint, it is done under ultrasound guidance.
You receive aftercare advice and a written report, which can be shared with your rheumatologist and GP.

Treatment options

Treatment for rheumatoid arthritis is led by a rheumatologist. It usually includes disease-modifying medicines, which aim to control the immune system and protect the joints, along with support from physiotherapists, occupational therapists and specialist nurses. LSRI does not prescribe these medicines or manage your rheumatoid arthritis directly. Instead, we support your rheumatology team with:

Diagnostic imaging: ultrasound, MRI and X-ray to help confirm inflammation and look for joint damage, with a detailed report for your rheumatologist.
Monitoring: repeat imaging, where your rheumatologist feels it is useful, to help assess whether inflammation is settling on treatment.
Ultrasound-guided steroid injection: for a single joint or tendon sheath that is flaring, in liaison with your rheumatologist. Ultrasound helps place the injection accurately, and it can ease pain and swelling in that joint in the short term. You can read more about joint injections.
MSK specialist consultation: a review of your symptoms and imaging, with clear advice on next steps.

If you do not yet have a rheumatologist and your symptoms suggest inflammatory arthritis, we will advise you to seek an urgent rheumatology referral. Dr Sankaye can advise when a rheumatologist’s opinion is worthwhile, and his report can be shared with them. For tips on coping with flares, see our article on rheumatoid arthritis flare-ups.

Questions about rheumatoid arthritis

Can ultrasound diagnose rheumatoid arthritis?

Ultrasound cannot diagnose rheumatoid arthritis on its own, but it can show inflammation and early joint damage that support the diagnosis. The diagnosis is made by a rheumatologist using your symptoms, examination, blood tests and imaging together.

My blood tests are normal. Could I still have inflammatory arthritis?

Yes. Some people with rheumatoid arthritis have normal blood tests, especially early on. Imaging can help show whether joints are inflamed, and persistent joint swelling should always be assessed by a rheumatologist.

Do I need a referral from my rheumatologist?

No GP or specialist referral is needed to book a scan. However, we work best alongside your rheumatologist, and we are happy to share reports with them.

Can you treat my rheumatoid arthritis?

Treatment of rheumatoid arthritis, including disease-modifying medicines, is led by your rheumatologist. LSRI provides imaging to support diagnosis and monitoring, and ultrasound-guided injections for flaring joints in liaison with your rheumatology team.

Our clinics

Two clinics, one team

Dr Prashant Sankaye, Consultant MSK Radiologist, sees patients at Harley Street in central London and at our Northwest London clinic in Harrow. Call one number to book at either clinic.