เอกซเรย์มือขวา-Scleroderma: Look for soft tissue calcifications
-Sarcoid: Acroosteolysis can occur in 50% of patients with sarcoid of the hands. Look for small, cortical, punched-out lesions OR a permeative, lace-like pattern.
-Psoriasis: Look for erosive disease at the distal interphalangeal joints
Leprosy: Look for linear calcification of digital nerves
-Hyperparathyroidism: Also look for subperiosteal resorption
Burn: Look for contractures or soft tissue calcifications.
Frostbite: Usually spares the thumb.
-Epidermolysis bullosa: Disorder of marked skin fragility and blister formation.
-Hypertrophic osteoarthropathy: Look at soft tissues for clubbing of digits with flattening of nail bed angle and marked soft tissue swelling.
-Pyknodysostosis: Look for dense bones and transverse fractures.
-Infection: Always think of osteomyelitis. This case ended up being acute osteomyelitis of the index finger (white arrow) and old osteomyelitis of the middle finger (pink arrow).