A Patient Has Swelling and Tenderness in the Small Joints

A patient has swelling and tenderness in the small joints of both hands and reports several weeks of malaise and fatigue. A rheumatoid factor (RF) test is negative. What will the primary care provider do next?

A) Begin treatment with a biologic disease-modifying anti-rheumatic (DMARD) drug
B) Order radiographic tests, a CBC, and acute-phase reactant levels
C) Reassure the patient that the likelihood of rheumatoid arthritis is low
D) Refer the patient to an orthopedic specialist for evaluation and treatment