Weight loss and anemia. Joint deformity of both hands with multiple overlying skin nodules.
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Bilateral extensive erosive arthropathy involving all fingers intercarpal joints. Further degenerative changes are noted involving wrist and base of thumb.
Prior plate and screw fixation of the right distal radius.
Of note, these changes were not seen on hand x-ray two years prior (not shown).
Extensive erosive bilateral small joint arthropathy has a wide differential including:
- rheumatoid arthritis
- psoriatic arthropathy
- erosive osteoarthritis
Please see full list please see: erosive arthritis (differential).
In this case, skin nodules overlying hand joints were biopsied and the patient was found to have multicentric histiocytosis.