Bilateral polydactyly

Case contributed by Daniel J Bell
Diagnosis certain

Presentation

Any evidence of rheumatoid arthritis in a patient with bilateral polydactyly.

Patient Data

Age: 70 years
Gender: Male
x-ray

Bilateral bifid fifth metacarpals with duplication of the little fingers representing a form of post-axial polydactylism. Under the Duran classification system it would be termed a type IV-B, in view of the bifidity of the metacarpal of the little finger.

No evidence of an erosive arthropathy.

Case Discussion

Polydactyly of the hand is the presence of a supernumerary digit. It is commonly subdivided into three main types, dependent on the location of the extra digit in the hand, from commonest to rarest: post-axial (ulnar/little finger), pre-axial (radial/thumb), and central polydactyly. 

This is a case of post-axial polydactylism in view of the additional little finger, i.e. it is on the ulnar side.

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