Presentation
Bilateral hand and wrist pain concerning for arthritis.
Patient Data
Mild negative ulnar variance bilaterally. No other gross deformity is evident.
Minimal periarticular osteopenia in the fingers considering technique bilaterally.
Mild diffuse acro-osteolysis of the distal phalanges of 2nd and 3rd digits bilaterally with small soft tissue calcification adjoining the tuft of distal phalanx of the left 3rd digit is most consistent with scleroderma.
The joint spaces are preserved. No discrete joint erosions are evident.
Case Discussion
Acro-osteolysis, osteolysis of the distal phalanges of the hands, is associated with distal digital ischaemia, digital calcinosis, and severe sensory neuropathy 1. Scleroderma, a rare paediatric condition, is the cause in our case 2.
This case was submitted with supervision and input from:
Soni C. Chawla, M.D.
Health Sciences Clinical Professor,
Department of Radiological Sciences,
David Geffen School of Medicine at UCLA.
Attending Paediatric Radiologist,
Olive View - UCLA Medical Centre.
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