Presentation
Post fall.
Patient Data
An intraarticular, nondisplaced fracture extends through the distalradial epimetaphysis. Associated soft tissue swelling at the dorsal aspect of the distal radius and carpus.
Background severe ulnar deviation/subluxation in the 2nd through 5th
metacarpophalangeal joints. Hook erosions along the radial aspects of the second and third metacarpal heads.
Multifocal degenerative changes are also noted involving for example the 1st interphalangeal joint, 5th DIP joint and triscaphe joint. The pisiform is diminutive.
Case Discussion
Findings are most likely in keeping with Jaccoud arthropathy, for instance secondary to previous history of rheumatic fever, SLE, psoriasis, ankylosing spondylitis etc. Rheumatoid arthritis could also produce a similar appearance in the appropriate clinical setting. Clinical correlation is recommended.
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