Presentation
Fixed flexion at elbow plus ?synovitis. Previous injury to fingers ?erosive changes ?degenerative.
Patient Data
A degenerative pattern of arthritis is seen at the third MCP joints bilaterally more marked on the right than the left with quite prominent hooks laterally.
Early changes of osteoarthritis are seen at some of the small joints of the hand, including the interphalangeal joints of the thumbs.
No evidence of osteoarthritis around the wrist and no chondrocalcinosis.
Prominent osteophytes are seen around both elbow joints. Other features of osteoarthritis are not prominent.
It would be difficult to exclude an intra-articular body in either elbow joint, but there is no evidence of a joint effusion.
Some irregularity of the subchondral bone of the trochlear is noted bilaterally.
Case Discussion
Osteoarthritis at the elbow joints is said to be most commonly due to trauma including repetitive micro trauma. Although there is no chondrocalcinosis, the alternative is that this arthritis and the osteoarthritis of the third MCP joints may be due to crystal deposition. Hemochromatosis would need to be considered in the differential diagnosis.
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