A 56-year-old woman presents to her physician complaining of weight gain and joint problems.She is increasingly having difficulty walking up stairs and manipulating her fingers.Fingers in both hands as well as knees on both legs are equally painful and stiff.The symptoms have been progressing over the last 6 months.Rheumatoid factor is elevated,and antinuclear antibodies are not detected.Complement levels in her joints are less than the levels in her serum.This woman has:

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The patient's symptoms of joint pain and stiffness, along with an elevated rheumatoid factor and normal antinuclear antibodies, are consistent with a diagnosis of rheumatoid arthritis. The presence of complement levels in joints being less than serum is also a characteristic feature of rheumatoid arthritis. Systemic lupus erythematosus and Wegener's granulomatosis can also cause joint problems, but the absence of antinuclear antibodies and other symptoms make these less likely diagnoses. Hashimoto's thyroiditis is an autoimmune disorder affecting the thyroid gland and does not typically involve joint symptoms.

A 56-Year-Old Woman Presents to Her Physician Complaining of Weight