Morning Stiffness Lasting About in Medicine / Internal Medicine — 45yo Woman | Rheumatology | SMLE Q#17158
SMLE Question #17158
Medicine / Internal Medicine
Rheumatology
Objective: OBJ-383
Last updated: February 2026
A 45-year-old woman has 4 months of progressive pain and swelling in both hands. Symptoms involve the metacarpophalangeal and proximal interphalangeal joints bilaterally with morning stiffness lasting about 2 hours that improves with activity. Examination shows symmetric warmth, swelling, and tenderness of the second to fifth MCP and PIP joints bilaterally with reduced grip strength and no DIP nodal changes. Hand radiographs show periarticular osteopenia and marginal erosions at the MCP joints. What is the most likely diagnosis?
Continue in practice mode
Sign in and start a focused practice session to view options, submit your answer, and read the full explanation.