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Rheumatoid arthritis - bilateral 5th metatarsophalangeal joint erosions

Case contributed by Roberto Schubert
Diagnosis certain

Presentation

Long-standing rheumatoid arthritis (RA). Lateral forefoot pain and swelling.

Patient Data

Age: 70 years
Gender: Female

Joint space narrowing and marginal erosions at both fifth metatarsophalangeal joints. 

Case Discussion

Despite the increased sensitivity of other modalities (particularly MRI), radiography remains the mainstay of imaging in the diagnosis and follow-up of RA. It's possible to see in this case:

  • joint space narrowing: symmetrical or concentric
  • marginal erosions: due to erosion by pannus of the bony “bare areas

Similar to the hands, there is a predilection for the PIP and MTP joints.

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