Early Changes of Inflammatory Arthritis in the Hand

The subject in this picture is having difficulty straightening the fingers and they look puffy. In particular the MCPs of 2nd and 3rd digits look swollen and the proximal digits look puffy. Also note that there is a fullness just inferior to the right wrist that is probably involving the dorsal extensor tendon sheath. This will be seen better in the next picture. This could represent early RA based on the distribution. (Image Credit: Dr. Lori Albert)