Role and applications of 18FFDG PET/CT in the assessment of osteoarticular infection and inflammation - Part II

[18F]FDG PET/TC is an emerging tool in the evaluation of inflammatory arthropathies, characterised by their insidious course and clinical overlap. It allows detection of subclinical inflammation, assessment of systemic involvement and quantification of metabolic parameters useful in early diagnosis and therapeutic monitoring. In rheumatoid arthritis, it correlates with clinical indices (Disease Activity Score), serological markers (CRP, anti-citrullinated protein antibodies) and ultrasound findings, and facilitates the identification of complications such as cardiovascular and pulmonary involvement. In spondyloarthritis, its ability to identify enthesitis and peripheral synovitis is promising, although less studied. In addition, [18F]FDG PET/TC evaluates the response to biological treatments, helping to optimise therapeutic decisions. However, its implementation faces challenges such as lack of standardised indications, incidental findings and technical artefacts. Although not routinely recommended, its usefulness in specific settings underlines the need for further studies to consolidate its role in the management of these diseases. In this manuscript, we present a brief review providing general and practical information about the role of [18F]FDG PET/TC in inflammatory osteoarticular pathology, while "Role and applications of [18F]FDG PET/CT in the assessment of osteoarticular infection and inflammation - Part I" has addressed its role in infectious osteoarticular disease.[18F]FDG PET/TC is an emerging tool in the evaluation of inflammatory arthropathies, characterised by their insidious course and clinical overlap. It allows detection of subclinical inflammation, assessment of systemic involvement and quantification of metabolic parameters useful in early diagnosis and therapeutic monitoring. In rheumatoid arthritis, it correlates with clinical indices (Disease Activity Score), serological markers (CRP, anti-citrullinated protein antibodies) and ultrasound findings, and facilitates the identification of complications such as cardiovascular and pulmonary involvement. In spondyloarthritis, its ability to identify enthesitis and peripheral synovitis is promising, although less studied. In addition, [18F]FDG PET/TC evaluates the response to biological treatments, helping to optimise therapeutic decisions. However, its implementation faces challenges such as lack of standardised indications, incidental findings and technical artefacts. Although not routinely