Unusual and memorable
Unusual and memorable
| The first 150 words of the full text of this article appear below. |
A 36 year old woman developed seropositive
nodular erosive rheumatoid arthritis at the age of 18. There was no
evidence of psoriasis nor was there any family history of psoriasis or
psoriatic arthropathy. Despite therapeutic attempts with non-steroidal
anti-inflammatory drugs, D-penicillamine, azathioprine,
corticosteroids, and methotrexate, she developed over the years the
rare type (5%) of resorptive arthropathy of rheumatoid
arthritis,1 simulating typical changes of psoriatic
arthritis. Radiographs of the hands showed resorption of the ulnar
styloid, carpal collapse and pencil in cup deformities of the MCP
joints, with severe resorptive changes in the PIP joints (fig 1).
Multiple surgical procedures, including synovectomies, total hip and knee replacements had to be performed over the years. Other differential diagnosis of arthritis mutilans
include neuropathic arthropathies such as
syringomyelia and leprosy, and chronic
infections of the soft tissue. Multicentric reticulohistiocytosis may
also lead to resorptive arthropathy, and occasionally extensive
arthritis mutilans may be seen in
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