Long-standing hand deformity.
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Symmetric osteoarthritic changes with loss of joint space and marginal osteophytes, mainly affecting the interphalangeal joints. Some of the PIPJ show a "gull wing" appearance. Articular destruction at the fifth right PIPJ.
These findings are in keeping osteoarthritis - it may be degenerative but "gull-wing" pattern of deformity is suggestive of erosive osteoarthritis.