@Lupusreference With the availability of Mycophenolate and Biologicals as Rituximab ,and Belimumab, lupus kidney and Brain disease is brought in to early remission .So I prefer to use low dose steroid to 5 mg daily and then to Alternate day with adequate cslcium, vit D , and Bisphosphonates .
@Janetbirdope Puffy fingers ,mostly on mefial side
Webspace widening indicating tendonotis, splinter harmorrhage, ischaemia with skin limited gangrene, claw hand due to tendon atresion , Ssc with RA overlap,Expecting Vasculopathy ,
@Janetbirdope Would like to look for sensstions youch pain , temperature, ttophic changes.
Palpate bil unar nerves , look for nodules one the course of nerve , look for thickened greater auricular nerve to rule out Henson disease.