| This elderly patient presented with a progressive thumbnail deformity. A history of psoriasis was revealed only postoperatively... |
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| Plain films showed resorption of the distal two thirds of the distal phalanx: |
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| Comparison views of the opposite side: |
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| MRI demonstrated ill defined soft tissue replacement of the majority of the distal phalanx: |
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| With contrast enhancement of the transformed area: |
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| Exploration revealed no discrete tumor, and a nondiagnostic frozen section. Because of diagnostic uncertainty and in order to avoid intraoperative cross contamination, a cancellous freeze dried allograft was used as a terminal graft: |
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| This incorporated, with some terminal resorption: |
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acro osteolysis psoriatic osteolysis |
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