Presentation
Scleroderma and renal failure with bilateral hand pain.
Patient Data
Age: 50 years
Gender: Female
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Three views of each hand show symmetric advanced acro-osteolysis involving all but the right ring finger. Left long and ring finger show near complete absence of the distal phalanges. Moderate soft tissue prominence of the distal thumb is present bilaterally. No soft tissue calcifications. Middle and proximal phalanges are intact. Metacarpals and carpals have a normal configuration.
Case Discussion
Resorption of the distal phalanges is called acro-osteolysis. Numerous causes have been described for which there is a mnemonic. In our case, the findings are most likely due to the patient's known scleroderma.
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