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Polyarthritis and pitting oedema
Service de
Rhumatologie, Médecine Physique et Rééducation, Centre
Hospitalier Universitaire Vaudois, CHUV - 1011 Lausanne, Switzerland
Correspondence to: Dr J Dudler.
Accepted for publication 2 December 1998
| The first 150 words of the full text of this article appear below. |
 |
Case history |
|---|
CASE 1
A 74 year old white man presented with an abrupt onset of
metacarpophalangeal (MCP) and interphalangeal (IP) joint pains
associated with swelling of both hands. He had two hours of morning
stiffness but no other joint complaints or history of constitutional
symptoms. Past medical history was unremarkable except for diabetes
mellitus type 2 treated with oral antidiabetic drugs.
| Table Removed (Available Only in the Full Text) |
Examination showed gross pitting oedema of the dorsum of both hands with swollen and tender MCPs, severe tenosynovitis of the flexor tendons, and swollen and limited wrist movements. Both knees had painless small effusions. Other joints showed no signs of inflammation and no nodules were palpated.
The erythrocyte sedimentation rate was increased at 55 mm in the first
hour. Except for a mild inflammatory anaemia and hyperglycaemia between
8 to 10 mmol/l, the full blood count, renal, liver and thyroid function
tests were within normal limits. Electrophoresis demonstrated an acute
and subacute inflammatory pattern without
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