Round #5

• Back to Clinical History and Radiographs
• What is the Differential Diagnosis?
• What is the Correct Diagnosis?

Radiographic Findings

X-rays of the hands (Films 1-4)) show marked degenerative changes with osteophytosis (red arrows) and subchondral sclerosis at the IP joint of the thumb, DIP joints, and PIP joints bilaterally. Multiple central erosions (yellow arrows) are noted at several DIP and PIP joints. The MCP and carpal joints are spared. (yellow box)

Film 1

Film 2

Film 3

Film 4

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