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Left hand: Joint space narrowing with some peripheral erosions and subarticular geodes of the first metacarpophalangeal joint. Associated increased soft tissue swelling. Small erosions at the bases of the second and fourth proximal phalanges. Vascular calcification evident.
Right hand: Acro-osteolysis noted of the distal second distal phalanx, mildly progressed from 2011 x-ray, and to a lesser extent of the distal first distal phalanx. Erosion seen at the base of the proximal phalanx of the third digit.
Advanced degenerative change of the left first MCP joint. Acro-osteolysis of the right distal first and second phalanges. These changes may be seen in scleroderma.