Erosive Arthropathy in Systemic Scleroderma

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Abstract
ALTHOUGH the classic bony changes seen in systemic scleroderma may be accompanied by changes in the joints, only rarely is destruction of subchondral bone found in joint spaces.1-3 However, roentgenograms of the hand of a 64-year-old woman with systemic scleroderma who was seen recently at the Lahey Clinic showed a classic pencil-in-cup (mortar and pestle) deformity in the distal interphalangeal joints of the fifth digits of both hands. To the best of our knowledge, this abnormality has not been reported previously in systemic scleroderma, although it is common in psoriatic arthritis and described less frequently in rheumatoid arthritis. Report of a Case This patient had Raynaud phenomenon and stiffness of both hands of three years' duration. She denied dysphagia and diarrhea, but had one-flight dyspnea on exertion. She also had diabetes mellitus of eight years' duration. The patient did not have a history of psoriasis, nor did her relatives. Physical

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