Rui M Gomes, Dean R Cerio, Cyrus Loghmanee, Justin McKinney, Mili Patel, Janeen Miraglia, Manal Yousef-Bessler, Jonathan H Zippin, Audrey N Schuetz, Paulo Bandeira Pinho
An 87-year old Caucasian male with past medical history of rheumatoid arthritis (RA) and chronic kidney disease presents with left hand erythema, pain, tenderness, induration and edema. Clinically, these hand findings began proximal to the metacarpo-phalangeal joints and extended to the distal wrist. He was noted to have ipsilateral axillary lymph node enlargement but denied any constitutional signs or symptoms. Laboratory markers of inflammation were poor prognostic indicators due to relatively active RA, the use of chronic daily glucocorticoids and weekly adalimumab use...
2013: Journal of Clinical Medicine