An Unusual Presentation of Joint Inflammation in Pachydermodactyly
Bibliographic record
Abstract
A 24-year-old Chinese male presented with progressive symmetrical thickening of the soft tissue around the second to the fifth proximal interphalangeal (PIP) joints in both hands of 2 years' duration.Initially, he had no pain or functional limitation and no systemic symptoms.In the previous 5 months, he had slight pain, with limited range of motion in his right middle and ring fingers.There was no other notable medical history.Clinical examination showed enlargement and thickening of the skin of the second to fifth PIP joints (Figure 1).Laboratory tests did not show specific changes.Radiographs of the hands showed only soft tissue swelling.Ultrasound showed soft tissue hypertrophy around the previously described PIP joints (Figure 2A).No synovitis, effusion, or bone changes were found in the PIP joints from second to fifth left fingers and PIP joints of second and fifth right fingers.However, synovitis (Figure 2B) and cortical bone injury (Figure 2C) were revealed in PIP joints of right third and fourth fingers.A skin biopsy was performed at the PIP joint of the right fourth finger after an ultrasound scan.The histopathologic examination revealed epidermal hyperplasia with compact orthokeratosis.There was thickening of the dermis with an increase in the number of collagen fibers.These results were compatible with pachydermodactyly.Pachydermodactyly does not present with synovitis and cortical bone injury 1,2 .Synovitis is generally considered the characteristic feature of inflammatory joint disease; however, pachydermodactyly does not exclude other concurrent pathological conditions 3 .The clinical symptoms that are not related to pachydermodactyly warrant further investigation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".