To the Editor:
We thank the author for sparking a discussion about differences and similarities of radiographic pathologies between rheumatoid arthritis (RA) and spondyloarthropathies1. Indeed, it can sometimes be a challenge to discriminate at an early stage of the disease, especially when having only 1 diagnostic tool at hand, e.g., radiographic studies. However, the clinical description that we have included alongside the radiologic image2 excludes a differential diagnosis such as psoriatic arthritis. And clearly, one should “bear” in mind the most common cause for changes of the distal interphalangeal joints: Heberden nodes. We have to deny that our radiographs of hands with RA are identical to those presented by Rothschild, because the most distinctive difference between them is the fusion of the bases of the metacarpal bones in the bear’s paw.
REFERENCES
- 1.
- 2.