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Rheumatoid Arthritis

Alikhan MMA - MedPix (2007)

View Article: MedPix Image - MedPix Case

Affiliation: National Capital Consortium

ABSTRACT

Diagnosis: Rheumatoid Arthritis

History: 53 y.o. woman with bilateral hand pain that is severe in nature and continues to progress in severity. Despite many treatment modalities, she has had persistent and chronic pain that limits her quality of life.

Findings: Plain Radiographs: Both hands demonstrate bilateral symmetric severe proximal (MCP) joint space destruction with periarticular osteopenia and ulnar subluxation of the 1st and 2nd proximal phalanges on their respective metacarpals.

Ddx: Rheumatoid arthritis Psoriatic arthritis Amyloidosis Polyarteritis nodosa Viral arthritis (eg, rubella, hepatitis B, parvovirus) Whipple disease Scleroderma Paraneoplastic syndromes Multicentric reticulohistiocytosis Osteoarthritis (erosive)

Dxhow: Serology and Imaging

Exam: Elevated Rheumatoid factor Decreased renal function (increased serum creatinine and decreased GFR)

No MeSH data available.


AP view of the left hand demonstrates severe joint destruction of the metacarpophalangeal joints with ulnar subluxation of the 2nd proximal phalanx on the 2nd metacarpal (MCP ulnar subluxation). There is also joint space narrowing of the proximal interphalangeal joints. Periarticular osteopenia with joint space erosion of the carpal joints and distal radiolulnar joint as well as the radiocarpal joint are present. Incidentally noted, there is a K-wire (Kirschner wire) in the thumb. Labelled image.
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MPX2251_synpic60492: AP view of the left hand demonstrates severe joint destruction of the metacarpophalangeal joints with ulnar subluxation of the 2nd proximal phalanx on the 2nd metacarpal (MCP ulnar subluxation). There is also joint space narrowing of the proximal interphalangeal joints. Periarticular osteopenia with joint space erosion of the carpal joints and distal radiolulnar joint as well as the radiocarpal joint are present. Incidentally noted, there is a K-wire (Kirschner wire) in the thumb. Labelled image.


Rheumatoid Arthritis

Alikhan MMA - MedPix (2007)

AP view of the left hand demonstrates severe joint destruction of the metacarpophalangeal joints with ulnar subluxation of the 2nd proximal phalanx on the 2nd metacarpal (MCP ulnar subluxation). There is also joint space narrowing of the proximal interphalangeal joints. Periarticular osteopenia with joint space erosion of the carpal joints and distal radiolulnar joint as well as the radiocarpal joint are present. Incidentally noted, there is a K-wire (Kirschner wire) in the thumb. Labelled image.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2251&req=5

MPX2251_synpic60492: AP view of the left hand demonstrates severe joint destruction of the metacarpophalangeal joints with ulnar subluxation of the 2nd proximal phalanx on the 2nd metacarpal (MCP ulnar subluxation). There is also joint space narrowing of the proximal interphalangeal joints. Periarticular osteopenia with joint space erosion of the carpal joints and distal radiolulnar joint as well as the radiocarpal joint are present. Incidentally noted, there is a K-wire (Kirschner wire) in the thumb. Labelled image.

View Article: MedPix Image - MedPix Case

Affiliation: National Capital Consortium

ABSTRACT

Diagnosis: Rheumatoid Arthritis

History: 53 y.o. woman with bilateral hand pain that is severe in nature and continues to progress in severity. Despite many treatment modalities, she has had persistent and chronic pain that limits her quality of life.

Findings: Plain Radiographs: Both hands demonstrate bilateral symmetric severe proximal (MCP) joint space destruction with periarticular osteopenia and ulnar subluxation of the 1st and 2nd proximal phalanges on their respective metacarpals.

Ddx: Rheumatoid arthritis Psoriatic arthritis Amyloidosis Polyarteritis nodosa Viral arthritis (eg, rubella, hepatitis B, parvovirus) Whipple disease Scleroderma Paraneoplastic syndromes Multicentric reticulohistiocytosis Osteoarthritis (erosive)

Dxhow: Serology and Imaging

Exam: Elevated Rheumatoid factor Decreased renal function (increased serum creatinine and decreased GFR)

No MeSH data available.