Periarticular and subarticular erosive changes are present in relation to the first MTP joints bilaterally, and the IP joints of the big toes bilaterally. There are also changes of the intertarsal and MTP joints of the right foot. Subchondral sclerosis and erosions as well as marginal osteophytes are also present particularly in the first MTP joints bilaterally and the right TMT joints of the right foot. There is soft tissue swelling in relation to the involved joints.