[The distribution of destructive polyarthritic changes in the hand skeleton]

The distribution of common and erosive changes in advanced polyarthrosis is radiologically demonstrated in the hands of 32 patients. 23 of them showed erosive destructions in at least one joint. In general the alterations were symmetrical. Most of the destructions were seen in the distal and proximal interphalangeal joints, especially in DIP II, III, V and PIP III. Usually the thumb was spared. Most emphasis has been put on the differential diagnosis to rheumatoid arthritis and arthritis in psoriasis and gout. A recent concept concerning mechanical factors in the pathogenesis of so called primary osteoarthritis in the small finger joints is discussed.