Presentation
Pain in the hands and wrists. History of a chronic connective tissue disorder.
Patient Data
Age: 45 years
Gender: Female
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Radiographs of the hands, including Norgaard (ball-catcher's) views. There are multiple typical findings in SLE arthropathy, including
- marked contractures and subluxations in a bilateral symmetric pattern
- swan neck deformities, particularly in the right hand
- hooked heads of the second and third metacarpals
- juxta-articular osteopenia
- no erosions
- no soft tissue calcifications
Case Discussion
Systemic lupus erythematosus (SLE or just "lupus") is a connective tissue disorder that can result in multiple musculoskeletal abnormalities, including a characteristic arthropathy in the hands (sometimes called "lupus arthritis").
The joints are affected in this systemic disease in 75-90% of patients and radiographic changes include:
- subluxation/dislocation
- absence of erosions or loss of joint space
- bilateral and symmetric changes
- juxta-articular osteopenia