From the case:
Rheumatoid arthritis
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Hitchhiker's thumb and swan-neck deformities of multiple fingers. Subluxation of the metacarpophalangeal joints with telescoping of some. Advanced degeneration of the carpus.
Case Discussion
Radiographic features of rheumatoid arthritis of the hand include:
- periarticular osteoporosis, subluxation, dislocation and erosions
- metacarpophalangeal ulnar deviation
- Boutonniere deformity: hyperextension of DIP, flexion of PIP
- swan-neck deformity: hyperextension of PIP, flexion of DIP
- hitchhiker's thumb
- telescope fingers: shortening of phalanges due to dislocations
- ulnar and radial styloid erosions are common
- wrist instability: ulnar translocation, scapholunate dissociation