Licked candy stick - rheumatoid arthritis

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

Long-standing rheumatoid arthritis. No previous foot surgery or trauma.

Patient Data

Age: 60 years
Gender: Female

The distal 5th metatarsal has a tapered appearance towards the MTP joint.

The degree of bone resorption can be appreciated by comparison with the normal adjacent metatarsals.

An illustrative conceptualisation of how the sign for these radiological appearances arise.

Case Discussion

The licked candy stick appearance refers to tapering of the tips of the metacarpal bones, metatarsal bones, phalanges or clavicles and is typically associated with chronic rheumatological conditions:

The appearances result from bone resorption/destruction resembling the appearance of a candy stick that has been slowly deformed from licking.

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