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].