This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Integrated QBank, Subject name: Unknown
[{'content': 'A 40-year-old female patient presented to the OPD with joint pain in the wrist, MCP, PIP and DIP joints B/L. The involved joints were tender and swollen. Patient also gave a history of ceain skin lesions which occurred before the joints were involved along with ceain nail changes were also seen. Lab findings revealed HLA- B27 positivity. Which of the following x ray findings most commonly correlates with the above condition: - \nSelect and explain. \nA. <img style="max-width: 100%" src=" />, B. <img style="max-width: 100%" src=" />, C. <img style="max-width: 100%" src=" />, D. All of the above are seen.', 'role': 'user'}, {'content': 'Answer: A \nExplanation: This is a case of psoriatic ahritis. There is no sparing of DIP joint. 1st image shows the classical plaque of psoriasis. 2nd image shows the classical nail pitting. Option A shows pencil in cup deformity- seen in psoriatic ahritis Option B shows Z-deformity - seen in RA Option C shows spade phalanx - seen in acromegaly', 'role': 'assistant'}]