Raynaud’s and dysphagia. What about the hands?

Abstract

A 67-year-old man with known systemic sclerosis underwent routine follow-up radiographs of the hands. His medical history included Raynaud’s phenomenon and dysphagia, while C-reactive protein levels remained normal. Radiographs demonstrated acroosteolysis, characterized by sharply demarcated resorption of the distal phalangeal tufts. This finding represents a characteristic manifestation of advanced systemic sclerosis, reflecting chronic digital ischemia associated with microvascular dysfunction. Accompanying features may include sclerodactyly and soft tissue atrophy. Recognition of acroosteolysis is important for distinguishing systemic sclerosis from other causes of distal phalangeal bone resorption, including infection and inflammatory arthropathies.