Presentation
Atraumatic hand pain.
Patient Data
No fracture or malalignment.
The distal interphalangeal joints of the 2nd-5th fingers demonstrate some minor erosive change and joint space narrowing, with a typical seagull appearance, suggesting erosive osteoarthritis.
There is some periosteal re-absorption of the radial aspect of the 3rd and 4th middle phalanges, which is typical for renal osteodystrophy. No lucent osseous lesion identified to suggest Brown tumor. Bone density is within normal limits.
Soft tissue calcification noted at the ulnar aspect of the middle finger proximal phalangeal head, which is seen in patients with renal osteodystrophy.
Multiple surgical clips are noted along the radial aspect of the distal forearm, in keeping with an AV fistula. Vascular calcification noted
Case Discussion
The patient was on regular hemodialysis via the left forearm AV fistula for ESRF.
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