Hemochromatosis: hand arthropathy

Case contributed by Jan Frank Gerstenmaier

Presentation

This patient punched a wall and was assessed in the ED for a possible boxer's fracture.

Patient Data

Age: 50
Gender: Male

Radiographs of right hand

x-ray

There is metacarpophalangeal joint space narrowing and there are overhanging osteophytes of the metacarpal heads of the right index and long fingers. No fracture or dislocation.

Annotated image

Overhanging (hooked) osteophytes of the metacarpal heads of the right index. 

Case Discussion

The overhanging osteophytes (a.k.a. hooked or beak-like osteophytes) at the heads of the metacarpals of index and long fingers are typical for hemochromatosis. Chondrocalcinosis is not prominent in this case. The main differential diagnosis of hemochromatosis is CPPD.

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