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Rheumatoid arthritis - wrist

Case contributed by Ahmed Abdrabou
Diagnosis almost certain

Presentation

Wrist pain and stiffness especially in the morning.

Patient Data

Age: 40 years
Gender: Male
mri

Wrist joint synovial hypertrophy with erosions of the distal radius and carpal bones, marrow edema of the capitate and lunate and mild joint effusion. Focal discontinuity of the triangular fibrocartilage at the ulnar side is also noted. No deformity seen.

Case Discussion

The patient was discovered to have Rheumatoid factor positive. The hallmark of rheumatoid is the formation of pannus, which is synovial hypertrophy in response to inflammation. Later on pannus erodes the articular surface of bone and cartilage and results in arthritis and bone deformity.

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