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 Best of Five 3.71

 

   

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BOF: 3.71

A 57-year-old female presents with a history of painful joints of several months duration. The pain mainly affects the small joints of both hands, they are swollen and stiff and the stiffness is worse in the mornings. She also complains of feeling generally unwell, fatigued, feverish and has lost weight.

On examination you note that there is symmetrical swelling of her wrists, the metacarpophalangeal joints and the proximal interphalangeal joints. There are nodules at both elbows.

In this patient which one of the following x-ray changes may be seen on x-rays of her hands?

a)      Subperiosteal resorption

b)      Periosteal reaction

c)      Looser’s zones

d)      Osteophyte formation

e)      Juxta-articular osteopaenia

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