U.C.L.A. Rheumatology Pathophysiology of Disease Course Lecture, Second Year Medical School 2005

      Another fairly common disease is displayed in this hand. Note that there is prominent swelling of a single MCP joint, whereas the others are spared. Also, there is involvement of the left third DIP joint with inflammation as well. This is a pattern of joint involvement that we have not seen yet.
      The xray shows severe erosive change of the right 2nd MCP.
      This patient has a spondyloarthropathy (SpA), which include Ankylosing Spondylitis, Reactive Arthritis (Reiter's Syndrome), Psoriatic Arthritis, the arthritis associated with inflammatory bowel disease (IBD), and Whipple's Disease. Undifferentiated SpA is also common. Delineation of the syndromes is to some extent arbitrary.