A 40-year-old female patient presented to the OPD with joint pain in the wrist, MCP, PIP and DIP joints B/L. The involved joints were tender and swollen. Patient also gave a history of ceain skin lesions which occurred before the joints were involved along with ceain nail changes were also seen. Lab findings revealed HLA- B27 positivity. Which of the following x ray findings most commonly correlates with the above condition:

A 40-year-old female patient presented to the OPD with joint pain in the wrist, MCP, PIP and DIP joints B/L. The involved joints were tender and swollen. Patient also gave a history of ceain skin lesions which occurred before the joints were involved along with ceain nail changes were also seen. Lab findings revealed HLA- B27 positivity. Which of the following x ray findings most commonly correlates with the above condition: –

A. <img style="max-width: 100%" src=" />

B. <img style="max-width: 100%" src=" />

C. <img style="max-width: 100%" src=" />

D. All of the above are seen.

Correct Answer: <img style="max-width: 100%" src=" />

Description: This is a case of psoriatic ahritis. There is no sparing of DIP joint. 1st image shows the classical plaque of psoriasis. 2nd image shows the classical nail pitting. Option A shows pencil in cup deformity- seen in psoriatic ahritis Option B shows Z-deformity - seen in RA Option C shows spade phalanx - seen in acromegaly

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