Gretchen is a 29 year-old African-American female who has come to the clinic com
ID: 3504815 • Letter: G
Question
Gretchen is a 29 year-old African-American female who has come to the clinic complaining of fatigue and anorexia. She is also experiencing joint pain and a rash. Her previous health history has been good until the past 6 months, during which she began experiencing fatigue and malaise along with a ten-pound weight loss. Over the past three months she has been having multiple joint and muscle pains and stiffness in the mornings. She has also noticed a rash on her face after being out in the sun. Her physical exam is normal except for the appearance of an erythematous malar rash, and warm, swollen, and tender PIP (proximal interphalangeal) joints of both hands. Urinalysis shows the presence of proteins and cellular casts and tests for antinuclear antibodies are positive.
What is the probable diagnosis? Which signs and symptoms led you to this conclusion?
Explanation / Answer
Probable diagnosis is Rheumatoid arthritis.main features are joint pain and muscle stiffness.
Presence of fatigue and Anorexia with a malar rash is characteristic of rheumatoid arthritis.
On investigation Positive ANA lead to Rheumatoid arthritis.
On examination tenderness of PIP joint. As DIP is spared in rheumatoid arthritis.
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