A 35 year old female presented with MCP and PIP pain. Diagnosis:: (A) Rheumatoid Arthritis, (B) Rheumatic fever, (C) Gouty arthritis, (D) Psoariatic arthritis
Answer is A. Ans. (a) Rheumatoid ArthritisRef: Harrison's 18th ed. Ch. 321Clinical Features of RA* Incidence of RA increases between 25 and 55 years of age.* Gender: Female > Male* Early morning joint stiffness lasting more than 1 hour and easing with physical activity.* The earliest involved joints are typically the small joints of the hands and feet.* The wrists, metacarpophalangeal (MCP), and proximal interphalangeal (PIP) joints stand out as the most frequently involved joints. Distal interphalangeal (DIP) joint involvement may occur in RA, but it usually is a manifestation of coexistent osteoarthritis.