Round #5

• Clinical History
• Radiographs
• Description of Radiographic Findings

Clinical History

The patient is a 68 year old woman with a history of hypercholesterolemia and hypothyroidism who presents to her physicians office complaining of progressive bilateral hand pain and worsening contractures of her fingers. She relates that she has had "arthritis" for many years, and it is now so severe that she is unable to care for herself. She denies any fevers or weight loss, and the remainder of her review of systems is unremarkable. Physical examination reveals marked bony hypertrophy at the PIP and DIP joints bilaterally, with severe contracture of her right index and ring fingers. Laboratory evaluation is unrevealing. Radiographs of the hands are obtained.

Radiographic Films

Film 1

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