Mutilans‐like arthropathy in mixed connective tissue disease

Patients who combine clinical features of various connective tissue disorders have been found to have antibodies to ribonucleoprotein. This antigen is included as the ribonuclease‐sensitive portion of an extractable nuclear antigen (ENA) (1). These patients have been grouped under the term mixed connective tissue disease (MCTD), and there is increasing evidence that they constitute a distinct disease group. Articular manifestations in patients with MCTD are prominent and may be destructive to the point of closely mimicking rheumatoid arthritis (2–4). Herein we describe a unique patient with MCTD who developed severe arthritis, as well as middle and distant phalangeal bone resorption which resulted in opera‐glass hands akin to those found in arthritis mutilans.