A 43-year-old female presented to a clinic with complaints of pain, swelling, and stiffness in the hands and feet. The patient reportedly had the symptoms for the past 5 years.
Medical History The patient had a 14-year history of pulmonary sarcoidosis Provisional Diagnosis Rheumatoid arthritis, empirically treated with nonsteroidal anti-inflammatory agents and prednisone Clinical Examination The patient had dactylitis in her second and third fingers of the right hand and also in the fifth finger of her left hand Second and fourth toes of both feet were found to be swollen Erythrocyte sedimentation rate (ESR) and angiotensin-converting enzyme (ACE) levels were elevated The test results for rheumatoid factor and anti-cyclic citrullinated peptide antibodies were negative Radiograph Analysis of Hands and Feet Revealed several circumscribed, corticated lytic bone lesions Presence of cystic…
