A 52-year-old woman comes to the physician because of a 3-week history of pain in her right knee. The pain is worse at the end of the day and when she walks. She says that it has become difficult for her to walk up the flight of stairs to reach her apartment. She has hypertension and psoriasis. Her sister has rheumatoid arthritis. She drinks two to three beers daily. Current medications include hydrochlorothiazide, topical betamethasone, and a multivitamin. She appears anxious. She is 160 cm (5 ft 3 in) tall and weighs 92 kg (202 lb); BMI is 36 kg/m2. Her temperature is 37.0°C (98.6°F), pulse is 87/min, and blood pressure is 135/83 mm Hg. Cardiopulmonary examination shows no abnormalities. There are several scaly plaques over the patient's upper and lower extremities. The right knee is not tender or erythematous; range of motion is limited. Crepitus is heard on flexion and extension of the knee. Her hemoglobin concentration is 12.6 g/dL, leukocyte count is 9,000/mm3, and erythrocyte sedimentation rate is 16 mm/h. Which of the following pathologic processes is most likely occurring in this patient's knee joint?

Question

Quizplus · Accepted Answer

Eductional Objective: Osteoarthritis is characterized by progressive fissuring and erosion of articular cartilage.  Risk factors include advancing age, obesity, joint trauma, and repetitive stress.  Patients may have mild effusion and crepitus on physical examination, but signs of synovitis (eg, redness, warmth) are less prominent than in the classic inflammatory arthritic disorders.

A 52-Year-Old Woman Comes to the Physician Because of a 3-Week