Splinter/linear hemorrhages
Linear hemorrhages, i.e. splinter hemorrhages, seen on the nails may be a clue to an underlying connective tissue disease, such as antiphospholipid antibody syndrome.
Heberden’s nodes
Heberden’s nodes in the DIP-joints due to formation of bony nodules, a clinical sign seen in patients with osteoarthritis. More commonly seen than Bouchard’s nodes.
Bouchard’s nodes
Bouchard’s nodes in the PIP-joints due to formation of bony nodules, a clinical sign seen in patients with osteoarthritis.
Figure – 14
Left/right hand radiograph in a patient with osteoarthritis (OA), which shows joint space narrowing of the DIPs, osteophytes, and bone remodelling. These radiographic features are typical in mild to severe OA.
Vasculitis
Note purpuric papules. (Courtesy Dr. A. Fam)
Figure – 9
Ring and long digit radiograph in a patient with psoriatic arthritis. There is loss of the tuft to the ring finger (arrow), so called acroosteolysis. The long finger shows soft tissue swelling (asterisk) with severe joint space loss and erosions at the proximal interphalangeal (PIP) joint. The bone density is increased involving the proximal and middle phalanx to the long finger (ivory phalanx) related to periostitis, a characteristic feature of psoriatic arthritis. (Courtesy of Dr. A. Donovan)
Figure – 8
Right foot radiograph in a patient with psoriatic arthritis. There is pencil-in-cup deformity involving the proximal interphalangeal (PIP) joint to the third toe (arrow). (Courtesy of Dr. A. Donovan)
Figure – 7
Left long finger radiograph in a patient with psoriatic arthritis and dactylitis. Note soft tissue swelling at the proximal interphalangeal (PIP) joint. Arrows show proliferative new bone formation. There is moderate joint space loss at the PIP joint. (Courtesy of Dr. A. Donovan)
Figure – 6
Left hand radiograph in a patient with rheumatoid arthritis shows extensive erosions at the distal radius, ulna, and carpus. Erosive changes are also seen at metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints. (Courtesy of Dr. A. Donovan)
Figure – 5
Right hand radiograph in a patient with advanced rheumatoid arthritis with erosions of the distal radius and ulnar styloid, as well as severe joint space loss with erosions throughout the carpus with soft tissue swelling. (Courtesy of Dr. A. Donovan)
