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Gull-wing appearance - erosive osteoarthritis

Case contributed by Mohammad Taghi Niknejad
Diagnosis almost certain

Presentation

Painful, swollen fingers of several months duration. Both hands are involved, and the pain became worse with activity and was relieved by NSAIDs.

Patient Data

Age: 60 years
Gender: Female

There is central erosions with marginal proliferation at both of the DIP and PIP joints. Diffuse loss of cartilage space is noted at inter-phalangeal and first carpometacarpal joints.

Annotated image

Circle highlights the gull-wing appearance of erosive osteoarthritis. 

Case Discussion

Central erosions with marginal proliferation at both of the DIP and PIP joints are compatible with gull-wing appearance. This appearance is consistent with erosive osteoarthritis.

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