Lupus arthritis--do we have a clinically useful classification?

Joint disease in SLE is common and has a significant impact on patients in terms of their burden of disease and quality of life. Despite this it remains largely understudied in comparison with the other inflammatory arthropathies. Newer imaging techniques are challenging the traditional concepts of a non-erosive arthropathy that is outlined in the ACR diagnostic criteria for SLE. MRI and musculoskeletal US techniques have been applied extensively in RA to detail the underlying joint pathology, to monitor response to treatment and to guide prognosis. The advent of biological therapies has revolutionized the treatment of RA and has again been borne out of an abundance of research that exists surrounding the underlying pathobiological inflammatory pathways. Unfortunately, no such unified body of evidence exists for lupus arthritis, which has made the development of an appropriate classification system somewhat difficult as our understanding remains incomplete.