Table 1

Techniques to assess hand bone damage in rheumatoid arthritis

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


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].

Geusens and Lems Arthritis Research & Therapy 2011 13:242   doi:10.1186/ar3375