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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

Operator-dependent

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].