Case history
Case history #1
A 60-year-old woman presents complaining of bilateral knee pain almost daily for the past few months. The pain was gradual in onset. The pain is over the anterior aspect of the knee and gets worse with walking and going up and down stairs. She complains of stiffness in the morning that lasts for a few minutes, and a buckling sensation at times in the right knee. On exam, there is a small effusion, diffuse crepitus, and limited flexion of both knees. Joint tenderness is more prominent over the medial joint line bilaterally. She has a steady but slow gait, slightly favoring the right side.
Case history #2
A 55-year-old woman has had pain and swelling in several fingers of both hands for the past 2 months. She describes morning stiffness lasting 30 minutes. Her mother tells her that she had a similar condition at the same age. She denies any other joint pain or swelling. On exam, she has tenderness, slight erythema, and swelling in one proximal interphalangeal joint and two distal interphalangeal joints in each hand. She has squaring at the base of her right thumb (the first carpometacarpal joint). There is no swelling or tenderness in her metacarpophalangeal joints.
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