A 42-year-old male patient with no known allergies and personal history of bilateral retinal detachment and cleft palate.
He was evaluated in the Traumatology Department due to a casual trauma on the dorsum of the right hand.
Erythema and swelling of the dorsum of the hand at the 4th metatarsal head level, mild pain to marked metaphalangeal joint of bone structures, and a limitation for complete flexure of the joint are observed.
The patient manifests that this limitation is prior to the trauma in several years.
It presents similar limitation in the contralateral hand that affects the same fingers, third and fourth.
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A simple X-ray of both hands was requested, which showed the absence of bone lesion in the contusion zone, and as a radiological finding, the presence of flattening of the heads with a corresponding metachilles lesion.
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Treatment was prescribed for contusion (resting, cryotherapy and taking NSAIs) and was scheduled in two weeks for a functional examination not altered by pain.
Two weeks later, the patient reported complete improvement of his traumatic process.
Decrease in the range of motion of the metaphalangeal joint is observed in both hands (normal values: extension 0-20o and flexion 0-90o) consisting of loss in the right hand of the last 30o
In the left hand, only the loss of the last 20o is observed in the flexion of the 3rd and 4th fingers (coincidence with less radiological affectation in this hand).
In spite of the radiological affectation of the most common, no mobility deficit was observed.
He has no pain at present or has suffered it in the past, and his main complaint is the limitation that he presents in activities that require the formation of a handful.
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Diagnosis: dieterich disease
