A 35-year-old male patient develops involvement of proximal and distal interphalangeal joints and Ist carpometacarpal joints with sparing of the wrist and metacarpophalangeal joint. The Diagnosis is:
In OA, most commonly affected joints include the hip, knee, and first metatarsal phalangeal joint (MTP) and cervical and lumbosacral spine. In the hands, the distal and proximal interphalangeal joints and the base of the thumb are often affected. Usually spared are the wrist, elbow, and ankle.
In gout usually only one joint is affected initially, but polyarticular acute gout can occur in subsequent episodes. The metatarsophalangeal joint of the first toe often is involved, but tarsal joints, ankles, and knees also are affected commonly.
In Pseudogout, the knee is the joint most frequently affected. Other sites include the wrist, shoulder, ankle, elbow, and hands. The temporomandibular joint may be involved.
Psoriatic arthropathy may involve peripheral joints, axial joints, or both. It most frequently presents as a polyarthritis or (less often) as an oligoarthritis;
Enthesitis, tenosynovitis, and dactylitis also are commonly present in combinations.
Involvement of the distal interphalangeal joints (DIP) is a characteristic feature and is present in 15% of cases.
In RA, the wrists, metacarpophalangeal (MCP), and proximal interphalangeal (PIP) joints stand out as the most frequently involved joints. Distal interphalangeal (DIP) joint involvement is relatively rare.