Swan neck deformity!

Swan neck deformity

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is a deformed position of the finger, in which the joint closest to the fingertip is permanently bent toward the palm while the nearest joint to the palm is bent away from it (DIP flexion with PIP hyperextension). It is commonly caused by injury or inflammatory conditions like rheumatoid arthritis or sometimes familial (congenital, like Ehlers-Danlos syndrome).
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💡Remember:
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🏥A 54 -year-old woman presents with swollen,painful hand and feets,Which are "stiffer in the mornings".
On examination there are signs of ulnar deviations and sublaxations of metacarpophalyngeal (MCP) joints .
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✔Dx :Rheumatoid arthritis.
Ulnar devations and sublaxation of joints are signs of advanced disease.
.. ( Rheumatoid Arthritis):
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-insidious onset.
-hands(PIP, MCP)exceptDIP, Wrist, ankels, knees
-inflammation present.
-systemic findings present.
-hand (Ulnar deviation , Swan nek and Boutnnnir deformity).
-⬆ESR &RF and anaemia
-X-ray (LESS):
L – loss of joint space
E – erosions
S – soft tissue swelling
S – soft bones (osteopenia)

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