Discussion in 'Spot Diagnosis' started by Egyptian Doctor, Nov 11, 2012.
What is your diagnosis ?
what i can spot
- Z deformity of the thumb - "Z-thumb" or "Z-deformity" consists of hyperextension of the interphalangeal joint (BOUTONNIERE DEFORMITY)+ flexion and subluxation of the metacarpophalangeal joint and gives a "Z" appearance to the thumb.
- total subluxation of MP joint at index and middle finger (so ulnar deviation is not that evident).
- ulnar deviation of MP joints at ring and little finger
- BOUTONNIERE + SWAN Neck of ring finger
all of the above + the osteoarthritc changes seen at most joints i.e joint space narrowing, subchondral sclerosis and bone loss ( i didn't spot any osteophytes..but i am sure they will b evident on better resolution X ray.
Preface - although each of these individual changes can be seen in osteoarthritis. Such a grand coming together will be seen classically in Rheum. Arthritis !
X ray of hand of a person with rheumatoid Arthritis.
narrowed joint spaces , displacement of the thumb and fingers, = Rheumatoid Arthritis
Answer : Rheumatoid Arthritis
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