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A 43-year-old woman presented with pain, swelling, and stiffness in the hands and feet; she reported having had the symptoms for the previous 5 years. Possible rheumatoid arthritis had been diagnosed and was treated with nonsteroidal antiinflammatory agents and prednisone. Pulmonary sarcoidosis had been diagnosed 14 years earlier. On examination, the patient had dactylitis of the second and third fingers of the right hand and the fifth finger of the left hand. The second and fourth toes of both feet were swollen. The erythrocyte sedimentation rate and level of angiotensin-converting enzyme were elevated. Test results for rheumatoid factor and anti–cyclic . . . [Full Text of this Article] |
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