New 3D imaging trial in Exeter aims to detect rheumatoid arthritis earlier

Patients in Exeter are set to become the first in the UK to trial a new 3D imaging technology that researchers hope could help diagnose rheumatoid arthritis earlier and prevent long-term joint damage.

The University of Exeter has begun live trials of the Adaptix Ortho350, a portable imaging system funded with just under £1 million from Innovate UK. 

The device produces 3D images at a similar cost and radiation dose to traditional X-rays, but with significantly more detail, giving clinicians a clearer view of early inflammatory changes in joints.

Rheumatoid arthritis affects an estimated 18 million people worldwide, according to University of Exeter experts. 

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The autoimmune condition causes the immune system to attack healthy tissues, leading to pain, swelling, stiffness and, if untreated, permanent joint damage. 

Early diagnosis is considered critical, yet conventional X-rays can fail to detect early signs of the disease.

Recruitment for the Exeter trial is through the Royal Devon rheumatology department, meaning participants need to be referred via that route. 

The study will compare the new imaging technology with standard 2D X-rays, focusing on diagnostic accuracy, joint-space measurement, and bone-density assessment.

Traditional X-rays often miss subtle early changes, contributing to delays in diagnosis.

The first participant in the Exeter trial, 45-year-old company secretary Emma Carnell, said the new technology could make a “huge difference” for people waiting for answers.

Ms Carnell was referred to the rheumatology department at the Nightingale Hospital in Exeter after experiencing sudden and unexplained pain while on holiday. 

Although initial X-rays and blood tests suggested no signs of rheumatoid arthritis, her consultant ordered an ultrasound, which revealed thickening of her joint lining and excess fluid in multiple joints, leading to a diagnosis.

She said the disease was not curable, but early detection and treatment could prevent irreversible joint damage and help manage symptoms.

“I’ve been lucky because my GP acted quickly to get me the right tests and treatment,” she said. “If this new 3D imaging can detect people earlier, it could stop more people reaching the point of lasting damage.”

The Exeter trial will compare the new imaging technology with existing 2D X-rays across three main areas: diagnostic accuracy, joint-space measurement and bone-density assessment.

Professor Karen Knapp, who is leading the study, said: “Up to 50 per cent of people with early joint changes are missing using 2D X-rays.”

“MRI and CT scans offer more detail but are costly and often have long waiting lists. The Adaptix Ortho350 promises clearer visualisation of inflammation and subtle joint erosion, which could allow treatment to start earlier.”

Adaptix’s Chief Medical Officer Dr Siân Phillips said the technology uses Digital Tomosynthesis to create a series of image slices that form a 3D picture.

“It provides clearer visualisation than standard X-rays at a lower dose than CT,” she said. “It’s portable, fast, and can be used at the point of care.”

The device has already been used in veterinary and industrial settings, with the Exeter study marking its first live clinical trial in human patients.

The trial will involve adults with rheumatoid or inflammatory arthritis of the hand. 

Participants will receive both types of imaging, with results assessed by researchers at the University of Exeter in collaboration with the Royal Devon University Healthcare NHS Foundation Trust and the NIHR Exeter Biomedical Research Centre.

If successful, the technology could offer clinicians across the NHS a new tool for catching the disease at an earlier (and more treatable) stage.