Chapter 3. Physical examination of the hand

Q 23. A 47 year old woman presents with painful swollen fingers that are worse on arising in the morning. She is quite busy in her law practice and writes and types all day. She believes that she has carpal tunnel syndrome. On examination her fingers seen to be angled or drifting to the ulnar side of the hand. Radiographs show joint changes at the MCP joint. What is your diagnosis? lace coverd with long sleeve wear for the prom occasion

Answer. Rheumatoid arthritis. The patient has the classic morning stiffness, swollen fingers, ulnar drift of the fingers and radiographic findings.