Pachydermodactyly in an 11-Year-Old Female: A Multimodal Ultrasonography Perspective.

BACKGROUND

Pachydermodactyly (PDD) is a rare benign fibromatosis that mimics inflammatory arthritis, posing diagnostic challenges in pediatric populations.

CASE PRESENTATION: We report an 11-year-old female with unilateral proximal interphalangeal (PIP) joint swelling.

IMAGING FINDINGS: Gray-scale ultrasound revealed symmetric dermal thickening (2.02 mm) with hypoechoic texture, while Doppler confirmed absent vascularity. Shear wave elastography demonstrated elevated tissue stiffness (shear wave velocity: 4.8 m/s).

CONCLUSION

This case underscores the utility of non-invasive multimodal ultrasonography in differentiating PDD from inflammatory arthropathies, avoiding unnecessary biopsies and therapies.