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Table 1 Techniques to assess hand bone damage in rheumatoid arthritis

From: Osteoimmunology and osteoporosis

  Studied features Advantages Disadvantages
CR Bone erosion Gold standard Low sensibility
  Joint space narrowing Easy accessibility
Low cost
High specificity
No evaluation of bone density Ionizing radiation
MRI Bone erosion Early detection of bone erosions Expensive
  Bone edema Prediction of erosive progression Uncomfortable
  Synovitis Monitoring bone change No evaluation of bone density
  Tenosynovitis Measurement of erosion volume
Absence of radiation exposure
CT Bone erosion High resolution No evaluation of bone density, synovitis, and bone edema Ionizing radiation
US Bone erosion Non-invasiveness No evaluation of bone edema
  Synovitis Easy accessibility Sensibility depending on joint accessibility
  Tenosynovitis Low cost  
  Bone density Monitoring bone change
Investigating cortical and trabecular bone separately
Absence of radiation exposure
DXA Bone density Early detection of bone damage
Small effective radiation dose
No evaluation of bone erosion, bone edema, and synovitis
DXR Bone density Better reproducibility than DXA
Higher sensitivity than DXA
Predictive of erosive disease
No evaluation of bone erosion, bone edema, and synovitis Ionizing radiation
  1. CR, computed radiography; CT, computed tomography; DXA, dual-energy x-ray absorptiometry; DXR, digitalized radiogrammetry; MRI, magnetic resonance imaging; US, ultrasound. Reprinted with permission from Elsevier [73].