A 55-year-old woman with inflammatory hand arthritis has radiographs showing central erosions of the proximal interphalangeal joints with a characteristic 'gull-wing' appearance. The diagnosis is:

• A Rheumatoid arthritis
• B Psoriatic arthritis
• C Erosive osteoarthritis ✓
• D Gout

Explanation

Erosive osteoarthritis is a subset of osteoarthritis that affects the interphalangeal joints of the hands and is characterised by central articular erosions that produce a 'gull-wing' or 'seagull' appearance on radiographs. This pattern distinguishes it from the marginal erosions of rheumatoid arthritis and psoriatic arthritis. Gout typically causes punched-out erosions with overhanging edges. Erosive osteoarthritis is more common in postmenopausal women and often involves the distal interphalangeal joints.

Reference: Apley's System of Orthopaedics and Fractures, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.