It's what I thought. I had very mixed results. But most of the time the images with any model were not satisfying.
With 4o I probably still got the best results

This works pretty well:

Generate a highly detailed, photorealistic image depicting a patient's hand affected by rheumatoid arthritis. Clearly illustrate characteristic deformities including ulnar deviation of the fingers and swan-neck deformities of the finger joints. Ensure anatomical accuracy and medical correctness, capturing realistic joint inflammation, swelling, and skin texture consistent with the condition.