A 32-year-old nurse presented with a complaint of intermittent episodes of pain, stiffness, and swelling in both hands and wrists for approximately 1 year. She reported that the episodes last for several weeks and then resolve. Recently, she started noticing similar symptoms in her knees and ankles. The joint pain and stiffness were making it difficult for her to get out of bed and were interfering with her ability to perform her duties at work. The joint stiffness usually lasted for several hours before improving.
She also reported malaise and easy fatigability for the past few months, but denied having a fever, chills, skin rashes, or, weight loss. Physical examination Blood pressure: 120/70 mmHg; Heart rate 82 bpm; Respiratory rate 14 breaths per minute. No rashes on the skin Head, neck, cardiovascular, chest, and abdominal examinations were normal. There was no hepatosplenomegaly.…
