Fig. 1.

(a1, a2) patient (II). Multiple bony abnormalities present, particularly involving the heads of the middle phalanges characterized by irregularity, flattening, and radial angulation. Bilateral symmetric marked joint space loss of the 2nd-5th DIP and PIP joints, 1st IP joints, left 5th MCP and right 2nd MCP joints. Osteophyte formation in a similar distribution with a subchondral cyst in the left 3rd DIP. Shortening of the middle phalanges, worst at the second and fifth digit is seen. (b1, b2) patient (I). Short and broad middle phalanges bilaterally, worst at the 2nd and 5th fingers. Irregularity and sloping of the 2nd -5th middle phalangeal heads with resultant radial deviation. No secondary degenerative changes. (c) 19-year-old man reported by Jawad et al. with Thiemann disease. There is flattening and irregularity of the phalangeal epiphyses and broadening of the PIP and DIP joints. There are signs of secondary osteoarthritis including joint space loss and osteophyte formation. Mild shortening of 2nd-5th middle and distal phalanges. (d) 17-year-old boy reported by Nurdan Kotevoglu-Senerdem et al. with Thiemann disease. There is irregularity, fragmentation and flattening of the 2nd-4th PIP and DIP joints. (e) 25-year-old women reported by Seçkin et al. with Thiemann disease. Note irregularity and flattening of the epiphyses and flexion deformity of both fifth finger PIP joints. There is thickening at the base of all proximal phalanxes and all middle phalanxes were broad. There is narrowing at the third and fourth DIP and fifth PIP joints of both hands. (f) Thiemann disease case report of a 10-year-old female by Molloy et al. There are dense sclerotic distal phalangeal epiphyses (ivory epiphyses). There is broadening and irregularity of the 2-5th middle phalangeal bases with premature physeal fusion and relative shortening. Mild ulnar deviation of the right third PIP joint. Note: permissions were obtained from the copyright holder to reuse the images c,d,e and f