A 55-year-old female presents with 3 months of slowly progressive pain in her hands, knees and feet. She has noted swelling in the wrists, MCP'S, PIP'S and knees. There is also pain across the metatarsal region and she has had difficulty finding comfortable shoes. She has no prior joint complaints.
Past Hx: Unremarkable ROS: Marked fatigue Physical Examination: Synovitis of both wrists, 2 nd , 3 rd & 5 th MCP bilaterally PIP bilaterally both knees MTP are very tender General exam is unremarkable. What are your diagnostic thoughts related to this case? What tests should be considered to confirm the case? *This case is from the Docplexus Editorial Team and is meant for educative purpose only.
