Hemochromatosis-associated arthropathy

Case contributed by Chris O'Donnell
Diagnosis certain


Severe hand and feet pain

Patient Data

Age: 65 years
Gender: Male

Hands and wrists


Gross arthritic change in the MCPs with hook osteophytes (arrows) and relative sparing of the 1st metacarpal bases as well as the DIPs and PIPs.

Feet and ankles


Ankles are also arthritic with hook osteophytes especially involving the talo-navicular articulations.

Case Discussion

Long-standing, biopsy proven hemochromatosis. 

It is difficult to separate primary osteoarthritis and hemochromatosis-associated arthropathy. The major distinguishing features are patients being younger males with affected joints being the wrists and MCPs, whereas osteoarthritis affects the first MCP base as well as the PIPs and DIPs in a patient population of older women. Hook or beak-like osteophytes are a feature of hemochromatosis.

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