Type 2 Diabetes Has in Medicine / Internal Medicine — 52yo Woman | Rheumatology | SMLE Q#18150

SMLE Question #18150

Medicine / Internal Medicine Rheumatology

Objective: OBJ-RA-001

Last updated: February 2026
A 52-year-old woman with type 2 diabetes has 6 months of bilateral hand pain with morning stiffness lasting 90 minutes. She reports swelling and tenderness of the metacarpophalangeal and proximal interphalangeal joints and difficulty making a fist. She also has gritty, dry eyes for several months and denies skin thickening. Examination shows symmetric synovitis of the 2nd and 3rd MCP and PIP joints bilaterally. What is the most likely diagnosis?

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