A 55-year-old woman presents to her general practitioner with several weeks of pain in the left hand. She remembers tripping in the garden and landing on her left outstretched hand previously but had not attended the accident and emergency department, as she did not feel she had sustained a fracture. She is otherwise fit and well. Her symptoms include pain (which she describes as ‘burning’ type), tenderness and swelling in the left hand. Examination On examination, there is wasting of the intrinsic muscles of the hand associated with evidence of sweating, warmth and flushed, shiny skin.
There was evidence of hyperaesthesia, hyperalgesia, and allodynia. There was no evidence of synovitis or deformity, however. The GP decided to refer the patient to her local hospital for an X-ray (images attached). What abnormality do you notice on these hand radiographs? *This case is from Docplexus…
