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Rheumatoid arthritis with ‘tram-tracks’ and ‘signet rings’
  1. Ashish Sharma1,
  2. Anish Kapil2
  1. 1 Department of Rheumatology, Fortis Hospital, Noida, Uttar Pradesh, India
  2. 2 Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
  1. Correspondence to Dr Ashish Sharma, Department of Rheumatology, Fortis Hospital Noida, Noida 110070, India; ash.blueney{at}

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A 54-year-old man presented with a history of cough, expectoration and breathlessness which had been worsening over the past 1 year. He did not have fever, night sweats or weight loss. He had been diagnosed to have rheumatoid arthritis 8 years ago. Examination showed synovitis in the metacarpophalangeal joints and wrists; deformities suggestive of rheumatoid arthritis were seen in multiple joints. Auscultation of the chest revealed bilateral infrascapular coarse crepitations. Interstitial lung …

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  • Contributors Both the authors contributed equally to the preparation of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.