Atypical OA changes of the hands and elbows

Case contributed by RMH Core Conditions

Presentation

Fixed flexion at elbow plus ?synovitis. Previous injury to fingers ?erosive changes ?degenerative.

Patient Data

Age: 70 years
Gender: Male
Modality: X-ray

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.

Modality: X-ray

 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. Haemochromatosis would need to be considered in the differential diagnosis.

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Case Information

rID: 28941
Case created: 23rd Apr 2014
Last edited: 17th Feb 2016
Inclusion in quiz mode: Included

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