Morning Stiffness in Medicine / Internal Medicine — 38yo Woman | Rheumatology | SMLE Q#16548
SMLE Question #16548
Medicine / Internal Medicine
Rheumatology
Objective: OBJ-383
Last updated: February 2026
A 38-year-old woman has 3 months of symmetric pain and swelling in the MCP and PIP joints with morning stiffness. She reports pleuritic chest pain and shortness of breath, intermittent fever, and unintentional weight loss. Chest X-ray shows a small pleural effusion. Examination shows synovitis of both hands without a cardiac murmur, conjunctivitis, or urethral discharge. What is the most likely diagnosis?
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