A 54-year-old woman is reviewed in the rheumatology clinic. Patient History: She was diagnosed with seropositive rheumatoid arthritis 14 years ago with prolonged early-morning stiffness, a small-joint arthropathy and a marked acute-phase response (elevated ESR and C-reactive protein). Her livelihood is at risk as she is unable to type effectively. Physical Examination: On examination, the patient has marked synovitis with tenderness and swelling of many of her metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints.
A radiograph of hand and wrist was ordered (image attached). What is the possible diagnosis and treatment in this case? *This image based case is from Docplexus Editorial Team for educative purpose only Image Source: 100 Cases in Orthopaedics and Rheumatology
