A 13-year-old girl with Aicardi-Goutieres syndrome. She has long history of arthritis, nodular rash, and chilblains started at the age of 2 years. Anteroposterior radiograph of the right hand demonstrates diffuse periarticular osteopenia, soft tissue swelling of the proximal interphalangeal joints (PIPs), mainly the third and fourth PIPs (arrows). There are no erosions, joint space narrowing or soft tissue calcifications. Similar changes are present in the left hand (not shown)