right first metacarpus on the following day the subject reported a remission of inflammation with a return of range of motion of the irradiated joints without pain three days later 200 joules were irradiated at the palmar and dorsal as well as the left first metacarpus a remission of inflammation was recorded the following day with a return of normal range of motion without pain of the irradiated joints the next day the palmar and dorsal surfaces were irradiated as well as the left second metacarpal and left proximal phalange with 100 joules the following day the subject reported a reduction of inflammation and pain of the irradiated joints two days later the subject was irradiated with 200 joules on the palmar and dorsal the left second metacarpal and the left second proximal phalange the subject experienced remission of inflammation the following day the next day the subject was irradiated with 200 joules palmar and dorsal on the remaining metacarpals and phalanges the subject experienced overnight remission of inflammation and pain one month later the right plantar and dorsal metatarsals and proximal phalanges were irradiated with 1200 joules on each surface for a total of 4800 joules the subject experienced a remission of inflammation and pain on the following day the left plantar and dorsal and metatarsals and proximal phalanges were radiated with 1000 joules on each surface for a total of 4000 joules a remission of inflammation and pain was reported by the subject approximately one year later the subject reported symmetrical recurrence of pain and inflammation in the first metacarpals the subject was irradiated on the metacarpals and proximal phalanges en bloc for a total of 6000 joules subject reported a positive response as there was a remission of inflammation and pain a.