R. CUSACKCARRIE ANNMD
A 16-year-old boy presented with asymptomatic progressive symmetrical thickening of the soft tissue around the proximal interphalangeal (PIP) joints of both hands of 2 years' duration. His medical history was remarkable for attention-deficit/hyperactivity disorder, for which he was prescribed methylphenidate hydrochloride. For the past 2 to 3 years, he and his psy-chiatrist had noted the development of a nervous tic consisting of stretching out the arms, grasping his fingers tightly across the PIP joints, and pushing externally. There was no other notable medical history, and his development was otherwise normal. No family members were similarly affected.
Tollefson MM, Wright TI, Davis DMR, DYSON SW, JUNKINS-HOPKINS JM, VINCENT L, ROSENMAN KS. Soft-Tissue Swelling Around the Proximal Interphalangeal Joints Bilaterally—Quiz Case. Arch Dermatol. 2008;144(12):1651-1656. doi:10.1001/archderm.144.12.1651-a