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Ulnar deviation and subluxation of the metacarpophalangeal joints. Degenerative change at the 1st carpometacarpal joint. No erosions identified.
Findings are in keeping with Jaccoud arthropathy, which can be seen in numerous conditions including rheumatic fever, SLE, psoriatic arthritis, and inflammatory bowel disease. This patient had a long history (15+ years) of SLE.