Scleroderma with acro-osteolysis

Discussion:

Acro-osteolysis due to scleroderma (confirmed subsequently). This case is interesting in that the presenting history and isolated radiographic appearance of the thumb was suspicious for osteomyelitis however the bilateral nature of the abnormality on bone scan and negative gallium scan ultimately led to the diagnosis of scleroderma with the identification of more extensive acro-osteolysis of other fingers.  No cause for the short 5th metacarpals was identified.    

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