Scleroderma - musculoskeletal manifestations in the hands
{"favouriteUrl":"/cases/scleroderma-musculoskeletal-manifestations-in-the-hands/add_favourite?lang=us","favouriteId":190962,"favouriteKind":"case","loginUrl":"/sessions/new?lang=us\u0026return_to=%2Fcases%2Fscleroderma-musculoskeletal-manifestations-in-the-hands%3Flang%3Dus","unfavouriteUrl":"/cases/scleroderma-musculoskeletal-manifestations-in-the-hands/remove_favourite?lang=us"}
Presentation
Bilateral hand and finger swelling.
Patient Data
Symmetrical severe joint space narrowing of the first carpometacarpal with radial subluxation and degenerative remodeling of the trapezium. Mild to moderate interphalangeal joint space narrowing. No joint erosion.
Left fourth proximal interphalangeal joint ankylosis in a fixed flexion deformity appears secondary to severe arthritis.
Left fifth finger fixed flexion with preserved interphalangeal joint spaces, possibly a soft tissue contracture.
Positive ulnar variance bilaterally. Alignment is otherwise within normal limits.
Extensive soft tissue and periarticular calcifications, particularly in the distal fingers/distal interphalangeal joints, base of thumb and wrist.
Partial resorption of the terminal tufts at the right second and fifth fingers in keeping with acro-osteolysis.
Case Discussion
This patient had a known history of scleroderma with typical x-ray findings of this condition:
extensive soft tissue calcifications
acro-osteolysis (mild in this case)
presumed soft tissue contracture of the left fifth finger
widespread arthritis - most severe at the base of thumb with radial subluxation, which is a common finding in patients with scleroderma
Unable to process the form. Check for errors and try again.