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A 15-year-old boy presented with swelling in his fingers, which had developed over 3 years. He had no history of trauma, pain and fever or morning stiffness. He was right-handed, with anxiety issues and also had repetitive finger friction behaviour. On examination, soft tissue swelling and skin thickening were observed in the lateral of the bilateral second to fourth proximal interphalangeal (PIP) joints bilaterally and left-hand second distal interphalangeal joints (figure 1). Complete blood counts, biochemistry and inflammatory marker levels were …
Contributors SY conceived of the presented idea; GK, SA and EÇ encouraged. All authors discussed the results and contributed to the final manuscript. SY, SA and GK wrote the manuscript with support from EÇ. EÇ performed pathological examinations.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.