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Hypertrophic osteoarthropathy is a medical condition combining clubbing and periostitis of the small hand joints, especially the distal interphalangeal joints and the metacarpophalangeal joints. Distal expansion of the long bones as well as painful, swollen joints [3] and synovial villous proliferation are often seen.
Heberden's nodes are hard or bony swellings that can develop in the distal interphalangeal joints (DIP) (the joints closest to the end of the fingers and toes). [1] They are a sign of osteoarthritis and are caused by formation of osteophytes (calcific spurs) of the articular (joint) cartilage in response to repeated trauma at the joint.
Joints of the hand, X-ray Interphalangeal ligaments and phalanges. Right hand. Deep dissection. Posterior (dorsal) view. The PIP joint exhibits great lateral stability. Its transverse diameter is greater than its antero-posterior diameter and its thick collateral ligaments are tight in all positions during flexion, contrary to those in the metacarpophalangeal joint.
Age. The risk of most causes of joint pain increases with age. This may be due to increased wear and stress on joints over time and a higher likelihood of other underlying medical conditions ...
Trauma deformities may manifest as reduced joint function due to lack of coordination in phalangeal joints, such as proximal interphalangeal flexion and distal interphalangeal hyperextension in boutonnière deformity. [1] Besides trauma, another reason boutonnière deformity may develop is due to a chronic disease like rheumatoid arthritis. [1]
However, in 15% of cases, the arthritis is symmetrical. The joints of the hand that is involved in psoriasis are the proximal interphalangeal, the distal interphalangeal, the metacarpophalangeal joint, and the wrist. Involvement of the distal interphalangeal joints is a characteristic feature present in many cases. [6]
The goals of treatment are to minimize symptoms such as pain and swelling, to prevent bone deformity (for example, bone erosions visible in X-rays), and to maintain day-to-day functioning. [104] This is primarily addressed with disease-modifying antirheumatic drugs (DMARDs); dosed physical activity; analgesics and physical therapy may be used ...
RS3PE typically involves the joints of the extremities, specifically the metacarpophalangeal and proximal interphalangeal joints, wrists, shoulders, elbows, knees and ankles. [4] It is more common in older adults , with the mean age between 70 and 80 years in most studies.