Tibial deviation or reverse lanois deformity of the toes is a seldom-seen abnormality, and the findings, in this case, are atypical for rheumatoid arthritis, but none-the-less consistent with the diagnosis which was known in this patient. With alignment deformities and a lack of bony erosion Lupus and Jaccoud arthroptahy should be primary considerations in absence of serologic and clinical data. Well managed Rheumatoid arthritis, as in this case, may present without erosions.