Psoriatic arthritis of hands

Case contributed by Alborz Jahangiri
Diagnosis almost certain

Presentation

Pain and swelling in the fingers.

Patient Data

Age: 40 years
Gender: Male
x-ray

Peri and subarticular erosive changes are present in relation to the third, fourth and fifth DIP and the 5th PIP joints on the left and the DIP joint of the right fourth and MCP joint of the fifth finger on the right. There is associated joint space narrowing. Marginal osteophytes are also present particularly in the right fifth MCP and the left IP joints

There is soft tissue swelling in relation to the involved joints. 

There is flexion deformity of the left fifth finger at the PIP joint, hyperflexion of the left PIP and flexion deformity of the left middle finger DIP joint.

Case Discussion

The patient had a history of psoriasis. The imaging features confirm psoriatic arthritis.

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