A 46-year-old female presented to a clinic with complaints of difficulty in walking due to worsening knee pain for the past 3 months. Medical history The patient was diagnosed with rheumatoid arthritis 12 years ago, for which she had received inconsistent treatment. The treatment was frequently switched between prescribed medical therapies and complementary medicine practices.
Physical examination Nodular swelling and presence of outward bowing of both knees Limited range of motion in left shoulder and both wrists and knees The number of the tender and swollen joints, the disease activity score and the elevated C-reactive protein level of the patient were consistent with the diagnosis of active rheumatoid arthritis. Radiograph analysis Radiograph analysis of both knees revealed the presence of multiple calcified loose bodies and narrowing joint space (Figure 1a, anteroposterior view;…
