Very little literature exists on the clinical value of 18F-FDG PET/CT in rheumatoid arthritis (RA), but the potential for initial diagnosis of RA merits further studies with more rigorous design and scan parameters mimicking the clinically relevant anatomic areas. The same goes for other aspects of the use of FDG in the setting of RA although these are even less covered, i.e. the potential of FDG as a sensitive early marker for therapeutic response and cardiovascular risk. Although the results show interesting potential, the true value remains to be convincingly demonstrated. This review provides an overview of the available literature in 18F-FDG PET/CT in rheumatoid arthritis.