A 19 year old man attended hospital after his recent discharge from the navy owing to his hand arthropathy. His symptoms began aged 14 years with swelling but no pain or disability of his distal interphalangeal (DIP) and proximal interphalangeal (PIP) finger joints. At the age of 17 he joined the navy and 1 year later began to experience considerable pain in his hands while carrying out his duties. He was reassigned and after 3 months of light duties was symptom free, although his joints …