Please click to enlarge.
Note what signs you see.
I (W. Wertelecki, M.D.) see inflamatory signs of small articulations (joints) of the hands, including some nodules on the metacarpophalangeal areas.
PERSPECTIVE: this illustration underscores the role of nosology (knowledge of the natural biologic behavior of “diseases”) – in this instance, how well the limited signs illustrate fit the two most likely categories of “juvenile arthritis” – rheumatic fever or juvenile rheumatoid arthritis. The differential analysis (diagnosis) requires a review of “positive” as well as “negative” (positively documented absence) signs (symptoms are signs as well) – critical (discriminatory) signs include a recent history of a “sore throat”, fever, skin rash, involuntary movements, pain, etc. (OR THEIR ABSCENCE). Please consult standard sources of medical information and decide what hypothetical diagnosis will you formulate.