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A case of upper-extremity destructive hypertrophic arthritis in a 64-year-old patient with diabetic neuropathy is presented. No previous report of such a lesion involving the upper extremity could be found.As an increasing number of well controlled diabetic patients attain a longer life span, the incidence of diabetic neuropathy will rise, as will the incidence of associated arthropathies.Diabetic neuroarthropathy was first described by Jordan in 1936 (1). More than 100 cases of this abnormality have been reported since. The tarsal, metatarsal and interphalangeal joints were involved in the majority of the published cases. In a few instances, the ankle and knee joints were affected. No case report of a diabetic neuroarthropathy involving the upper extremity has come to our attention. The purpose of this report is to present a patient with diabetic arthropathy of the upper extremity. CASE ABSTRACTL.C., 64-year-old Negro female, was admitted to Bird S. Coler Hospital with a long-standing history of rheumatoid arthritis, chronic pyelonephritis and anemia. She complained of fatigue, anorexia and inability to walk.The physical examination revealed bilateral flexion contractures of the knees and hips. A shallow skin ulcer, measuring 3 em in diameter, was present over the left hip area. The right wrist was markedly deformed. It was painless and could be put through a full range of passive motion. There were minimal rheumatoid changes in the fingers of both hands.The neurological examination revealed decreased tendon reflexes of both lower extremities, a diminished biceps tendon reflex of the right arm, no Babinsky signs bilaterally, and decreased vibratory sensation in the right upper extremity. The pupils were unequal and reacted poorly to light, but accommodation seemed normal.There was no history of any systemic or intraarticular corticosteroid therapy. Laboratory dataThe laboratory findings were as follows: Hematocrit, 29 per cent; hemoglobin concentration, 8.6 gm per 100 ml; leukocyte count, 5,840 per cu mm with a normal differential; reticulocyte count, 0.6 per cent; platelets, 270,000 per cu mm; spinal fluid analysis-no cells, and negative results with the Kolmer test for syphilis.