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Hand Xray

Discussion in 'Spot Diagnosis' started by Egyptian Doctor, Nov 11, 2012.

  1. Egyptian Doctor

    Egyptian Doctor Moderator Verified Doctor

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    What is your diagnosis ?

    HAND XRAY.jpg
     

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  2. neo_star

    neo_star Moderator

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    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.

    My Diagnosis

    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.

    (-:
     

  3. nagu000in

    nagu000in Young Member

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  4. Rocket Queen

    Rocket Queen Super Moderator

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  5. dupuytren

    dupuytren Bronze Member

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    rheumatoid arthritis
     

  6. Gospodin Seki

    Gospodin Seki Moderator Staff Member

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    Rheumatoid arthritis
     

  7. dr.angela

    dr.angela Bronze Member

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    Rheumatoid Arthritis
     

  8. drkdab

    drkdab Active member

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    narrowed joint spaces , displacement of the thumb and fingers, = Rheumatoid Arthritis
     

  9. Egyptian Doctor

    Egyptian Doctor Moderator Verified Doctor

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    Answer : Rheumatoid Arthritis
     

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