Case presentation A 39-year-old female presented to an orthopedic clinic with plantar pain, a gait disturbance, and toe deformities in both her feet. The patient was examined previously and suspected to have rheumatoid arthritis by several orthopedic surgeons, but no definitive diagnosis was made. After that, she was prescribed nonsteroidal anti-inflammatory drugs. Radiographs Feet - Showed severe joint destruction in the proximal interphalangeal (PIP) joints of the lesser toes, with joint space widening and shortening of digits.
Hand and spinal -Radiograph findings were unremarkable. Clinical examination Rheumatoid factor and anti-cyclic citrullinated peptide antibody - Negative C-reactive protein level - Normal (0.10 mg/dL) No family history of psoriasis, psoriatic arthritis, and rheumatic diseases No skin irregularities were observed on the feet. A rash was observed on the chest. A…
