PMC6649904_01
Destruction of the distal IP joints with ankylosis of the right wrist and evanescent rash.. (A) Erythematous macules involving the right arm. (B) A radiograph of the hands shows severe structural destruction in the distal IP joints of both hands with erosions and ankylosis of the right wrist.
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Also, the clinical profile was very different from a PsA: high fever, evanescent rash (Fig. 1A), pharyngitis and high serum ferritin with low glycosylated ferritin (1%). An X-ray of her hands (Fig. 1B) showed multiple subchondral erosions and narrowing of the joint spaces in the wrists with ankylosis in the right wrist and severe injuries with subluxations in the distal IP joints of the hands (first and fourth right fingers and first and fourth left fingers).