A 76-year-old woman presents to an out-patient clinic complaining of gradually progressive, nonpainful enlargement of the terminal joint on her left hand over a 9-month period. She has some stiffness with typing but not first thing in the morning. She also reports pain in her right knee, which occasionally “locks up.” The right knee also hurts after long walks. Physical examination Her blood pressure is 130/85 mm Hg, heart rate- 80 bpm, and weight- 285 lb. Examination reveals only a nontender enlargement of her left distal interphalangeal (DIP) joint, and the right knee is noted to have crepitus and slightly decreased range of motion.
There is no redness or swelling. What is the diagnosis and best initial treatment for this condition? (Answer will be posted soon!) *This patient case is from the Docplexus Editorial Team for educative purposes only. Source: Clinical Cases In Internal…
