1. Late radiographic findings in rheumatoid arthritis in the hands of three patients. (A) Radiographs of the hands reveal a symmetric polyarthropathy involving the distal radioulnar, radiocarpal, intercarpal, carpometacarpal, and metacarpophalangeal articulations, with joint space narrowing, periarticular osteopenia, and erosions at multiple sites. There is radial deviation at the radiocarpal articulation, but no obvious ulnar deviation at the metacarpophalangeal joints. Note that the distal interphalangeal joints are spared. (B) Lateral radiograph of the hand in another patient shows a swan-neck deformity of the middle finger: flexion of the metacarpophalangeal and distal interphalangeal joints and hyperextension of the proximal interphalangeal joint. While not pathognomonic, swan-neck and boutonnière deformities (not shown) are more often seen in rheumatoid arthritis than in the other inflammatory arthritides. (C) Frontal view of the hand reveals joint space narrowing and erosions at the radioulnar, radiocarpal, intercarpal, carpometacarpal, and metacarpophalangeal articulations. There is also dorsal subluxation at the interphalangeal joint of the thumb, giving the so-called hitchhiker's thumb deformity.
Source: Musculoskeletal, Introduction to Diagnostic Radiology
Citation: Elsayes KM, Oldham SA. Introduction to Diagnostic Radiology; 2015 Available at: Accessed: January 02, 2018
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