Dietrich disease (metacarpal head avascular necrosis)
Old female seamstress with a painful and swollen third metacarpophalangeal joint of the right hand. These symptoms had started six months previously, without trauma.
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Xray right hand
Partial collapse of third metacarpal head.
Dietrich's disease is extremely rare and has been associated with trauma, systemic lupus erythematosus, congenitally short digits and steroid use.
Case courtesy: Prof. Fabio Denicolò