# Idiopathic isolated bilaterally symmetrical brachymetacarpia of the fifth metacarpal in a woman with rheumatoid arthritis

## TL;DR

A 60-year-old woman with rheumatoid arthritis had a rare, harmless skeletal variation in her fifth metacarpal bones.

## Contribution

Highlights a rare, asymptomatic skeletal variant in a rheumatoid arthritis patient with no underlying syndrome or metabolic cause.

## Key findings

- The patient had bilaterally symmetrical brachymetacarpia of the fifth metacarpal bones.
- No symptoms or functional impairment was observed despite the radiographic anomaly.
- Extensive testing ruled out syndromic or metabolic causes for the skeletal variation.

## Abstract

We report a rare case of idiopathic, isolated, and bilaterally symmetrical brachymetacarpia of the fifth metacarpal bones in a 60-year-old woman followed for seropositive rheumatoid arthritis. Despite the radiographic anomaly, the patient remained asymptomatic and had normal hand function. Extensive investigations ruled out syndromic or metabolic causes. This case emphasizes the importance of recognizing rare skeletal variants in rheumatologic evaluations.