Hand osteoarthropathy in pianists.

We evaluated radiographs of the hands of 20 pianists. The radiologic manifestations arising from long-term stress and strain applied to the hands were recorded. The changes are characterized by: 1) alignment adaptation consisting of axial radial rotation of the digits, particularly the fifth but also the third and fourth, 2) degenerative changes at the distal interphalangeal DIP and metacarpophalangeal MCP joints, and 3) mechanical remodeling manifested as periostal thickening and flattening of the phalangeal tufts associated with sclerosis. These findings suggest the existence of an occupational entity which might be described as pianist's osteoarthropathy.