A 38-year-old woman is being evaluated because of pain and stiffness in both of her hands for the past 2 weeks. The pain is most severe early in the day and does not respond to ibuprofen. She has no other medical problems. Family history is significant for hypertension on her maternal side. Vital signs are within normal limits. Examination shows swelling and tenderness of the wrists and metacarpophalangeal joints bilaterally. Range of motion is decreased due to pain. There are subcutaneous, nontender, firm, mobile nodules on the extensor surface of the forearm. Autoantibodies against which of the following components are most specific for this patient's condition?

Question

Quizplus · Accepted Answer

Eductional Objective: Rheumatoid arthritis is characterized by symmetric polyarthritis (involving the metacarpophalangeal and proximal interphalangeal joints) with prolonged morning stiffness and associated fatigue.  Antibodies to citrullinated peptides/proteins have a high specificity for the condition.

A 38-Year-Old Woman Is Being Evaluated Because of Pain and Stiffness