BMJ Case Reports 2013; doi:10.1136/bcr-2013-200035

Opera glass hands: the phenotype of arthritis mutilans

  1. António Marinho
  1. Department of Internal Medicine, Centro Hospitalar Porto, Porto, Portugal
  1. Correspondence to Dr Maria Betânia Ferreira, betania_ferreira82{at}


A 51-year-old man was diagnosed with psoriatic arthritis at the age of 18.

For the last 20 years he refused treatment, abandoned any follow-up and was unseen by any health professional. The patient became unable to walk 17 years ago and then went blind 10 years ago.

The patient entered the emergency room prostrated; on examination, he was found …

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