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Asymmetric involvement is more commonly seen at the metacarpophalangeal joints and at the wrist. The case above is a somewhat extreme example in a patient with positive rheumatoid factor. There are advanced findings of rheumatoid arthritis centered at the right wrist without significant abnormality in the other joints or on the left side.
References
- Clarke GS, Buckland-Wright JC, Grahame R. Symmetry of radiological features in the wrist and hands of patients with early to moderate rheumatoid arthritis: a quantitative microfocal radiographic study. Br J Rheumatol. 1994 Mar;33(3):249-54.
- Zangger P, Keystone EC, Bogoch ER. Asymmetry of small joint involvement in rheumatoid arthritis: prevalence and tendency towards symmetry over time. Joint Bone Spine. 2005 May;72(3):241-7.
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