The second patient presents slight stiffness in the flexion of PIP joint of the fourth right digit and a 40[degrees] flexion of the distal interphalangeal joint
of the fourth right digit.
In PPRC, joint stiffness usually first affects the hips and progressively involves the other joints, especially the proximal and distal interphalangeal joints
. In the patients presented in this study, both siblings had stiffness and osteoarthrosis on both hip joints and an enlargement of interphalangeal joints
1 4 4 -- -- 2 4 3 -- -- 3 4 4 -- -- 4 3 4 Pain over the YES plate 5 4 3 Wound dehiscence YES and infection 6 3 4 -- -- 7 3 4 Extensor tendon YES adhesion 8 4 4 Fracture YES 9 3 4 -- -- M, male; F, female; y, year; m, month; Stage, Steinbrocker stage; F-U, follow-up; CMJ, carpometacarpal joint; MPJ, metacarpophalangeal joint; IPJ, interphalangeal joint
; DIPJ, distal interphalangeal joint
; Auto, autograft; Alio, allograft; MC, metacarpal.
Then the intermediate digit gets contacted with object surface and stop rotating around proximal interphalangeal joint
. Finally, the distal digit rotates until it gets contacted with the object.
Nail changes are a marker of psoriatic arthritis, and magnetic resonance imaging showed that nail enthesis is associated with the nail, the distal phalanx, and distal interphalangeal joints
and therefore may cause PsA .
Clinical examination of his hands revealed isolated ulnar deviation of the second fingers and symmetrical deformity of proximal interphalangeal joints
of both hands (Figure 2).
proximal interphalangeal joint
tenderness, right knee joint swelling, and right wrist joint tenderness.
LJM usually begins at the fifth interphalangeal joints
and extends radially, affecting other interphalangeal and metacarpophalangeal joints.
(ii) Lower limb joints included in PE tools may contain the hip, knee, ankle, subtalar (rear foot), talonavicular and calcaneocuboid (midfoot), metatarsophalangeal (forefoot), and proximal and distal interphalangeal joints
Digit III (medial or main toe) has 4 phalanges with 3 interphalangeal joints
(Figs 1 and 2).
The proximal interphalangeal joints
, metacarpophalangeal joints, elbows, and knees are mainly involved in reactional states of leprosy, which are also commonly involved in SLE, adding a further diagnostic dilemma.
Physical examination revealed flexion contractures, progressive swelling and stiffness of the interphalangeal joints
. Limitation of motion was progressive.