Table 1 |
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Techniques to assess hand bone damage in rheumatoid arthritis |
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Studied features |
Advantages |
Disadvantages |
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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 |
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|
Tenosynovitis |
Measurement of erosion volume Absence of radiation exposure |
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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 |
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Tenosynovitis |
Low cost |
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Bone density |
Monitoring bone change Investigating cortical and trabecular bone separately Absence of radiation exposure |
Operator-dependent |
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|
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 |
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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]. |
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Geusens and Lems Arthritis Research & Therapy 2011 13:242 doi:10.1186/ar3375 |
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