Diagnosis in art: Dr Dorothy Hodgkin (1910–1994)

In 1985—the same year as Live Aid, the Broadwater Farm riots, the Bradford Football club fire and the Manchester Airport disaster—Dr Dorothy Hodgkin sat for this portrait. Dr Hodgkin was a pioneer in the field of chemistry, and was awarded the Nobel prize in 1964. As part of a vast body of work, she identified the chemical structure of penicillin, Vitamin B12 and insulin.

In this painting, we see Dr Hodgkin working in her home in Warwickshire. She is depicted with four arms to portray the frenetic energy of her work, and a model of insulin is shown as a note to her discovery. One other notable anomaly is visible; her hands show the classic deformity of rheumatoid arthritis. Significant swelling to the metacarpophalangeal joints is visible with radial shift of the metacarpals and ulnar displacement of the phalanges.

In this case, Dr Hodgkin's rheumatoid arthritis was diagnosed at age 24, and it progressed throughout her life, resulting in her increasing use of a wheelchair. If she were your patient, you could suspect that her disease would limit her ability to undertake some daily tasks, and that she may be taking a number of analgesics, anti-inflammatories and possibly disease-modifying antirheumatic drugs.