Transition to Artificial Intelligence in Imaging and Laboratory Diagnostics in Rheumatology

Artificial intelligence (AI) is rapidly transforming rheumatology, particularly in imaging and laboratory diagnostics where data complexity challenges traditional interpretation. This narrative review summarizes current evidence on AI-driven tools across musculoskeletal ultrasound, radiography, MRI, CT, capillaroscopy, and laboratory analytics. A structured literature search (PubMed, Scopus, Web of Science; 2020–2025) identified 90 relevant publications addressing AI applications in diagnostic imaging and biomarker analysis in rheumatic diseases, while twelve supplementary articles were incorporated to provide contextual depth and support conceptual framing. Deep learning models, notably convolutional neural networks and vision transformers, have demonstrated expert-level accuracy in detecting synovitis, bone marrow edema, erosions, and interstitial lung disease, as well as in quantifying microvascular and structural damage. In laboratory diagnostics, AI enhances the integration of traditional biomarkers with high-throughput omics, automates serologic interpretation, and supports molecular and proteomic biomarker discovery. Multi-omics and explainable AI platforms increasingly enable precision diagnostics and personalized risk stratification. Despite promising performance, widespread implementation is constrained by significant domain-specific validation gaps, data heterogeneity, lack of external validation, ethical concerns, and limited workflow integration. Clinically meaningful progress will depend on transparent, validated, and interoperable AI systems supported by robust data governance and clinician education. The transition from concept to clinic is under way—AI will likely serve as an augmenting rather than replacing partner, standardizing interpretation, accelerating decision-making, and ultimately facilitating precision, data-driven rheumatologic care.