I used to work with a lady whose hands actually looked like that. I don’t remember what happened that made them that way. Her thumb knuckle was at a 90 degree angle like that 😳
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I have a patient with lupus whose hands look just like that. She is getting ready to have the surgeries to regain, flexibility and range of motion in them.
Now that you say lupus it may have been that. That sounds familiar. My aunt also has lupus and has some issues with her hands, but not that extreme.