Plain film radiography

After half an hour of clinical examination and investigations, postero-anterior and dorsal radiographic images were performed for both hands by a radiologist who was unaware of the clinical history or findings, using an Optima XR220amx X-ray machine (GE Healthcare, USA). The specifications for plain film radiography were single-screen, high-resolution, single-emulsion, focus field distance 104 cm (41 inches), 101 mA, 49–56 kV at 301 ms [18]. Any disagreement between radiological interpretation regarding erosion or synovitis was overcome by discussion among radiologists.