A Clinician Is Evaluating a Client with Rheumatoid Arthritis

A clinician is evaluating a client with rheumatoid arthritis.In addition to the client-centered interview,occupational profile,and occupational performance evaluation,the therapist wishes to document the clinical status.The clinician notices severe hand deformities and joint enlargements that may make goniometric measurements difficult.How should the therapist go about documenting digit flexion?

A) The therapist will be unable to measure the joint flexion because of the deformities.
B) The therapist should measure the distance from the fingertips to the distal palmar crease with a ruler.
C) The therapist should measure over the joint enlargements at each joint.
D) The therapist should account and subtract for the enlarged joint in determining the joint flexion.