RESEARCH ARTICLE Evaluation of hand bone l i S In

Full list of author information is available at the end of the articleBackground Chronic synovitis in rheumatoid arthritis (RA) can lead to irreversible joint damage, which is seen on conven-tional plain radiography [1]. Measurement of the degree of joint damage represents an important tool to assess disease progression and effectiveness of current treat-ments [2,3]. Periarticular osteopenia, erosions and joint space narrowing are radiographic features of RA that can be seen on conventional radiography of the hands and feet [3,4]. Of these, periarticular osteopenia, reflec-ting a reduction in bone mineral density (BMD), is one of the earliest manifestations, and may precede erosion and joint space narrowing [4]; it may be caused by local release of inflammatory mediators and immobility [5,6]. The sensitivity of conventional radiography regarding osteopenia is limited, as it can only be detected if the reduction of bone density is more than 35–50 % [7,8]. In recent years, studies have been presented on an alternative method for ascertaining inflammation-related osteopenia in patients with RA, measuring BMD in the diaphyses o