A 34-year-old woman presented to the clinic with a 6-month history of pain in her hands. Six months back, the patient started to experience mild pain in her metacarpophalangeal joint (MCP). However, over a few weeks, the woman developed marked stiffness of both hands and wrists, along with excruciating pain, especially in the morning. She had earlier consulted a general practitioner (GP) for persistent pain. The GP had prescribed her with diclofenac that failed to relieve her pain.
The patient reported depression as she thought that she had developed rheumatism like that of her grandmother. Physical examination The patient had soft-tissue swelling of her wrists, MCPs, and numerous proximal interphalangeal (PIP) joints of her hands, along with a decreased bilateral grip strength. Additionally, the patient had a non-tender nodule on her elbow. Radiological examination A radiograph image…
