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Swelling of a metacarpophalangeal joint
  1. A Kumar,
  2. A P Thomas
  1. Department of Trauma and Orthopaedics, New Cross Hospital, Wolverhampton, UK
  1. Dr A Kumar, 99 Lea House, Bushey Fields Road, Dudley DY1 2LU, UK

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Answers on p 440.

A 60 year old man was referred to the orthopaedic clinic for swelling of the metacarpophalangeal joint of the right middle finger which had gradually increased in size over the last five years. He was being treated with oral anti-inflammatory drugs for occasional discomfort. There was no history of fever, trauma, or involvement of any other joint. He had no other relevant medical history. On examination there was a slightly tender partly cystic swelling over the dorsoulnar aspect of the head of the third metacarpal. There was a fixed flexion deformity of 10 degrees at the metacarpophalangeal joint but full flexion was possible. All the routine haematological and biochemical investigations were normal. A radiograph of the right hand is shown in the fig1.

Figure 1

Radiograph of right hand.

Questions

(1)
What does the radiograph show?
(2)
What is the differential diagnosis?
(3)
How would you treat this condition?

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