A 34-year-old postal worker presents to your health center for evaluation of pain in her joints. She states that the pain is worse in her fingers and wrists, both hands are affected. She notices that it takes longer than 1 hour to get moving in the morning because she is so stiff. For the past few weeks, she has been having fevers, some as high as 100.5 F degrees. You notice that she has fusiform swelling in her fingers and wrists bilaterally and that her PIP and MCP joints are tender to palpation. Based on the history and physical examination findings, what is the most likely etiology?

Rheumatoid arthritis.

Explanation:

Rheumatoid arthritis is a chronic disorder that results in inflammation of the joints. When this condition occurs, it deforms the joints which could lead to physical disabilities. This condition usually affects the fingers and toes and gradually spreads to other parts of the body such as the wrists, ankles, elbows, and hips. This condition is associated with severe pains, tender swellings, stiffness of the affected area which is usually worse in the morning, fatigue, fever. The symptoms may come and go, and causes discomfort in the joints. There are certain factors that predisposes a person to develop rheumatoid arthritis and they include:

-Age: This condition is common among older adults as they approach their 50's.

- Sex: Common among women than men due to the history of menstrual flow.

-Family history- Genetics plays a role in developing this health condition. It could be inherited.

- Life style such as smoking. Smoking can also complicate the situation especially if there is a history of rheumatoid arthritis in the family.

- Obese people are at a higher risk of developing the condition especially those in their middle age.

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