PMC5903491_01
Rheumatoid arthritis of the hand with deformity.
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She had been affected by RA for 13 years, RA was diagnosed based on the 1987 diagnostic criteria, according to which, the patient had bilateral hand polysymmetric inflammatory arthritis with morning stiffness for more than 1 hour and positive rheumatoid radiographic abnormalities on X ray (periarticular osteopenia, decreased joint space, and marginal erosions). She developed bilateral hand irreversible deformities within the first 2 years of her disease (ulnar deviation, Z deformity, swan neck, and boutonniere deformities), with restricted wrists movement and impaired hand grip (Figure 1).
Lupus nephritis: renal biopsy findings.
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Renal biopsy was performed and showed glomerulonephritis class 4 (Figure 2) according to the World Health Organization's lupus nephritis classification system.