Rheumatology Quiz (Eng)

Abstract

A 37-year-old healthy female with a history of surgically repaired right index finger fracture 2 years ago presented with a 17-month history of right forearm pain. She reported recurrent episodes of redness, swelling, warmth, and burning pain that began in her right index finger and gradually progressed to involve the right hand, forearm and elbow. Symptoms worsened with heat exposure and improved with cooling. Examination revealed erythema, mild edema, moist skin, and warmth over the right fingers and forearm (Figure 1). There was tenderness at the proximal interphalangeal joints and metacarpophalangeal joints with a flexion deformity of the index finger. The pain was disproportionate to light palpation and did not improve after a complete course of antibiotics. The physical findings and hand radiographs are shown in Figures 1 and 2, respectively.