Lupus arthropathy in the hands and wrists

Q: How does the appearance of systemic lupus erythematosus (SLE) in the hand and wrist differ from rheumatoid arthritis (RA)? show answer

A: SLE is a nonerosive arthritis. The subluxation and bilateral symmetric distribution are similar to RA, but in RA erosive changes accompany the joint laxity and articular deformities. If a wrist and hand appears to have advanced RA, but there are no erosions, consider SLE.

Q: SLE arthropathy often overlaps with other connective tissue arthropathies, including... show answer

A: Scleroderma, dermatomyositis/polymyositis, mixed connective tissue disease

Q: Why is the Norgaard (ball-catcher view) used if SLE arthropathy is suspected? show answer

A: In the standard PA view, the fingers are pushed into standard position. In the Norgaard view, the fingers are not positioned and potential subluxations are better seen.

Q: Do the subluxations in SLE arthropathy affect the joint space? show answer

A: Although there may be apparent narrowing of the joint spaces by subluxations, the joint spaces are actually preserved (which differs from rhematoid arthritis).