We thank Barnabe et al. for their interest in our article (Progress in imaging in rheumatology. Nat. Rev. Rheumatol. 10, 628–634; 2014),1 and for their helpful comments (High-resolution peripheral quantitative CT in rheumatology. Nat. Rev. Rheumatol. doi:10.1038/nrrheum.2014.145-c1).2

Their letter highlights the potential of high-resolution peripheral quantitative CT (HR-pQCT). This is really an emerging imaging technique which provides an in vivo assessment in patients with bone and joint diseases, opening a new dimension in the study of the bony microarchitecture.3

Although HR-pQCT has a wide range of applications in rheumatology, from osteoporosis to chronic arthritis, its use is still limited to a few research centres, and the difficulty in interpreting some potential pitfalls requires further studies to test the validity of HR-pQCT in large cohorts of patients.

In our article,2 which had to be concise due to the manuscript format, we decided to focus mainly on ultrasonography and MRI because these imaging techniques are more widely available.

Nevertheless, we agree with Barnabe et al.2 in believing that HR-pQCT can be considered one of the most promising imaging modalities, which will see researchers of different specialties working together to further clarify its use in patients with bone disorders and inflammatory arthritis.