Lupus arthropathy in the hands and wrists

Case contributed by Matt A. Morgan
Diagnosis certain


Pain in the hands and wrists. History of a chronic connective tissue disorder.

Patient Data

Age: 45 years
Gender: Female

Hand/wrist series


Radiographs of the hands, including Norgaard (ball-catcher's) views. There are multiple typical findings in SLE arthropathy, including

  • marked contractures and subluxations in a bilateral symmetric pattern
  • swan neck deformities, particularly in the right hand
  • hooked heads of the second and third metacarpals
  • juxta-articular osteopenia
  • no erosions
  • no soft tissue calcifications

Case Discussion

Systemic lupus erythematosus (SLE or just "lupus") is a connective tissue disorder that can result in multiple musculoskeletal abnormalities, including a characteristic arthropathy in the hands (sometimes called "lupus arthritis").

The joints are affected in this systemic disease in 75-90% of patients and radiographic changes include:

  • subluxation/dislocation
  • absence of erosions or loss of joint space
  • bilateral and symmetric changes
  • juxta-articular osteopenia

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.