Advanced rheumatoid arthritis

Case contributed by Bálint Botz
Diagnosis certain

Presentation

Rheumatoid arthritis diagnosed five years earlier. Lost to follow-up.

Patient Data

Age: 55 years
Gender: Female
x-ray

Striking, symmetric, erosive changes of the MCP-PIP, MTP-PIP joints, and the carpal joints (particularly on the right). Resultant subluxations in several joints. Sparing of the DIP joints. 

Case Discussion

With the advent of disease modifying antiheumatic drugs and biological therapy advanced manifestations as shown here can be mostly avoided. Untreated and uncontrolled rheumatoid arthritis however has a sinister course with substantial reduction in the quality of life. 

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