A 28-year-old female who had a 12-year history of type 1 diabetes mellitus reported to the hospital complaining of stiffness and dull pain in both her hands. She had been feeling stiffness for the last one year. She also complained of morning stiffness, limited movement of hand joints, and tightness of the skin. Her HbA1c ranged from 8.5 to 10%, and she showed poor glycemic control. She was on insulin and was found to have microalbuminuria and non-proliferative diabetic retinopathy.
She had no history of rheumatoid arthritis in her family. Tinel’s and Phalen’s tests were done to rule out carpal tunnel syndrome. No evidence of Dupuytren's contracture was observed. Her laboratory investigations were normal, but a mild prominence of proximal to mid-interphalangeal joint soft tissue was observed bilaterally. She was unable to lay her hands on a flat horizontal surface in a positive tabletop…
