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Pachydermodactyly: bilateral proximal interphalangeal joint swelling in an adolescent musician
  1. Arshak Shahenyan1,
  2. Svetlana Harutyunyan2,
  3. Margarita Nersisyan3 and
  4. Knarik Ginosyan2
  1. 1Department of Pathophysiology, Yerevan State Medical University Named after Mkhitar Heratsi, Yerevan, Armenia
  2. 2Department of Rheumatology, Yerevan State Medical University Named after Mkhitar Heratsi, Yerevan, Armenia
  3. 3Ultrasound diagnostics, Wigmore Clinic Medical Center Yerevan, Yerevan, Armenia
  1. Correspondence to Dr Knarik Ginosyan; kginosyan{at}


An otherwise healthy young man was referred to the rheumatologist because of bilateral proximal interphalangeal (PIP) joint enlargements. The main concern was excluding the presence of inflammatory arthritis. Physical examination revealed bilateral PIP finger joints (II-IV) swellings and cutaneous thickenings in adjacent areas. The specificity of this case was the patient who appeared in the physician’s room with his violin suitcase pointing to his profession even from the first site. Complete blood count with leucocyte differentials appeared without changes. Radiographics failed to show joint fluid or bony changes. All immunological markers (RF, anti-cyclic citrullinated peptide) and laboratory data (Erythrocyte sedimentation rate, C-reactive protein, etc) were within the reference ranges or negative. After exclusion of rheumatoid and other inflammatory arthritis, and considering the occupation of the patient and demographics the diagnosis of a rare condition–pachydermodactyly was made.

  • Musculoskeletal syndromes
  • Rheumatoid arthritis

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  • Contributors KG was the lead author for this case report, leading the initial patient care and management. AS was leading the writing of the manuscript. SH was also involved in patient’s management, formated pictures and contributed to the manuscript. MN was ultrasound specialist who contributed with radiographics.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.