The wink sign is associated with which condition?

• A. Rheumatoid arthritis
• B. Osteoarthritis
• C. Gout
• D. Psoriatic arthritis

Answer: (A)

In rheumatoid arthritis, inflammatory synovitis around the small hand joints can cause dynamic changes in the extensor tendons over the metacarpophalangeal joints. The wink sign reflects this tendon instability or subluxation that occurs with finger movement, making a tendon slip appear as if the finger is “winking.” This sign points to active inflammatory involvement of the MCP region seen in RA.

Osteoarthritis, gout, and psoriatic arthritis have different patterns: OA tends to show bony enlargements and joint space narrowing at Heberden/Bouchard nodes, gout presents with acute monoarthritis and tophi, and psoriatic arthritis often features dactylitis or nail changes with asymmetrical involvement.