“…These MRI findings also do not establish a disease severity. Distal phalangeal bone marrow edema-like changes can be nonspecific and are also demonstrated in a wide variety of diseases including fractures, crush injuries, insect stings or bites, osteomyelitis, serous bone marrow transformation pathologies, and seronegative spondyloarthropathies [19], [20], [21], [22], [23], [24], [25], [26]. Other limitations of this case include presentation confirmation in correlation to known disease and lack of histopathologic correlation.…”