
A 50 year-old physician experienced the abrupt onset of tenderness and swelling in the distal interphalangeal (DIP) joint of his right index finger. His only significant past medical history was Wolf-Parkinson-White syndrome, which was managed successfully with ablation. The same symptoms subsequently occurred in the DIP joints of his left index finger and fifth digits of both hands. No other digits were affected. The symptoms made it difficult for him to type on the computer. He denied trauma to the affected fingers, although he is an athlete and had had a left middle finger avulsion fracture, right middle finger dislocation, and left radial frac-ture. He had no systemic or other joint involvement.




