An 83-year-old Caucasian man presented to the author's hospital for study of hand swelling. The patient presented a bilateral hand dorsal pitting edema (Fig. 1) of one month of evolution with mild inflammatory pain on both metacarpophalangeal (MCP) and interphalangeal (IP) joints, 15 min of morning stiffness and limited movements of both wrists. There were no other joint complaints (such as shoulder or pelvic involvement), no jaw claudication nor headache and no constitutional or other systemic symptoms were present.
