Case presentation A 58-year-old female with a history of hypothyroidism presents with a history of joint pain and swelling for two weeks. The pain spread and affected the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of her fingers. Family history Two weeks prior to presentation at the clinic, her 5-year-old grandson developed fever, headaches, myalgias, malaise, and rash on the cheeks, trunk, and extremities. The previous week her 10-month-old granddaughter developed a similar febrile illness. The same week, her 25-year-old daughter developed headaches, malaise, and arthralgias (wrists and knees) but no rash or fever.
All the above manifestations resolved spontaneously within a week. Physical examination Afebrile with normal vital signs. Malar rash with no visible rash on the trunk or extremities. Swelling and tenderness of the MCP and PIP joints with difficulty…
