Question:
The patient is presenting with the deformity of the finger as shown. The PIP joint is involved but the DIP joint is spared. What is the diagnosis?
The patient is presenting with the deformity of the finger as shown. The PIP joint is involved but the DIP joint is spared. What is the diagnosis?
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Which inflammatory arthritis spares the DIP and produces swan-neck deformity?
Updated On: Jun 23, 2026
- Osteoarthritis
- Rheumatoid arthritis
- Psoriatic arthritis
- Ankylosing spondylitis
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Verified By Collegedunia
The Correct Option is B
Solution and Explanation
Step 1: The image shows a swan-neck deformity, which is hyperextension at the PIP joint with flexion at the DIP joint.
Step 2: This deformity, along with PIP involvement and DIP sparing, is classic for rheumatoid arthritis. RA characteristically attacks the MCP and PIP joints of the hand and spares the DIP joints, and chronic synovitis produces swan-neck and boutonniere deformities and ulnar deviation.
Step 3: Osteoarthritis does the opposite, it favours the DIP joints (Heberden nodes) and the PIP joints (Bouchard nodes) but does not give swan-neck deformity. Psoriatic arthritis classically involves the DIP joints with a pencil-in-cup change and dactylitis. Ankylosing spondylitis is an axial spondyloarthropathy of the spine and sacroiliac joints, not a small-joint hand deformity. The PIP-involved, DIP-spared swan-neck picture is rheumatoid arthritis.
Ref: Medscape, Swan-neck deformity in rheumatoid arthritis.
Step 2: This deformity, along with PIP involvement and DIP sparing, is classic for rheumatoid arthritis. RA characteristically attacks the MCP and PIP joints of the hand and spares the DIP joints, and chronic synovitis produces swan-neck and boutonniere deformities and ulnar deviation.
Step 3: Osteoarthritis does the opposite, it favours the DIP joints (Heberden nodes) and the PIP joints (Bouchard nodes) but does not give swan-neck deformity. Psoriatic arthritis classically involves the DIP joints with a pencil-in-cup change and dactylitis. Ankylosing spondylitis is an axial spondyloarthropathy of the spine and sacroiliac joints, not a small-joint hand deformity. The PIP-involved, DIP-spared swan-neck picture is rheumatoid arthritis.
Ref: Medscape, Swan-neck deformity in rheumatoid arthritis.
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