Images in Clinical Medicine

Arthritis Mutilans

Robert Monger, M.D., and Virginia Hrywnak, D.O.

N Engl J Med 2003; 349:1935November 13, 2003

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Article

A 94-year-old woman had rheumatoid arthritis that was diagnosed when she was 8 years old. She had not sought treatment for arthritis until she was in her 60s, and by then arthritis mutilans with multiple severe arthritic deformities had developed. Radiographs showed resorption of many of the bones of her hands and wrists. This resorption resulted in the collapse of the soft tissues of her fingers, a phenomenon sometimes referred to as “telescoping fingers.” The patient stated that her parents had had “rheumatism,” and the patient had a son who had rheumatoid arthritis.

Robert Monger, M.D.
Cheyenne Medical Specialists, Cheyenne, WY 82009

Virginia Hrywnak, D.O.
University of Wyoming, Cheyenne, WY 82001