Rheumatology Case 6

A 42 year old woman with a 6 year history of symmetrical polyarthritis presented with poor grip. Clinical examination revealed hypermobility of the finger joints, with shortened digits and excessive skin folds. The rheumatoid factor was positive and CRP and ESR were raised. Hand X-rays showed severe resorptive arthropathy affecting carpal and metacarpal joints. The differential diagnosis consists of:
1. Rheumatoid arthritis
2. Psoriatic arthritis  
3. Scleroderma/resorptive arthropathy  
4. Paraneoplastic resorptive arthropathy  




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