Joint disease is characteristically non-erosive and may affect both large and small joints. The proximal interphalangeal, knee, wrist and metacarpophalangeal joints are most most commonly involved. Deformities such as swan neck fingers and wrist ulnar deviation may be present but unlike those of rheumatoid arthritis, they reveal no bony erosions and are correctable. The synovial fluid is usually clear: no crystals or evidence of infection.
Aseptic necrosis of the femoral head, knee, or wrist may occur late in the disease in steroid treated patients.
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