Background: A 63-year-old female with relapsing-remitting arthritis of different joints including hip, knee, ankle, shoulder, elbow and wrist since 1986 presented. Despite medical treatment NSAIDs, and later on sulfasalazine and prednisolone therapy she continued to have active arthritis of several joints and developed mutilating deforming arthritis. In 2011 she presented at our outward patient clinic with progressive pain to her shoulders, elbows and wrists.
Clinical findings showed swelling, limited function of her shoulders, elbows and hands. Conventional radiographs were made of her shoulders, elbows, wrists and hands.