2 Months Of Pain in Medicine / Internal Medicine — 28yo Woman | Rheumatology | SMLE Q#11414
SMLE Question #11414
Medicine / Internal Medicine
Rheumatology
Objective: OBJ-383
Last updated: February 2026
A 28-year-old woman presents with 2 months of pain, swelling, and morning stiffness lasting about 2 hours in the metacarpophalangeal and proximal interphalangeal joints of both hands. She has difficulty making a fist on waking that improves during the day. She denies recent diarrheal illness, urethritis, or conjunctivitis. Examination shows symmetric swelling and tenderness of MCP and PIP joints bilaterally with reduced grip strength and no skin rash. What is the most likely diagnosis?
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