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Case contributed by Oliver Hennessy
Diagnosis almost certain


Joint pains ? erosive arthropathy.

Patient Data

Age: 90 years
Gender: Female

There are changes of advanced osteoarthritis involving the metacarpophalangeal joints of the index and middle fingers. Chondrocalcinosis is present at the wrist joint

There are no fractures identified.

The appearances are in keeping with hemochromatosis.

Case Discussion

Hemochromatosis is the accumulation of excess iron in the body. Most cases are genetically inherited, predominantly in an auto recessive manner. Acquired hemochromatosis usually results from repeated hemolysis and blood transfusions. Excess iron deposition is most often seen in the liver, heart, pancreas and joints.

Joint changes result from calcium pyrophosphate deposition leading to a destructive arthropathy in the hands and feet.

Imaging features in the hands:

  • chondrocalcinosis
  • marked narrowing of the metacarpophalangeal joints of the second and third digits
  • prominent bony beaks arising from metacarpal heads of affected joints is a prominent feature

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