A 45-year-old woman comes to a clinic with complaints of morning stiffness in her ankle joints,...
A 45-year-old woman comes to a clinic with complaints of morning stiffness in her ankle joints, worse on rising in the morning and improving during the day. Her discomfort is responsive to aspirin. She has also been fatigued and weak. During the last week, she has noticed that her wrist and ankle joints on both sides of her body are also painful and swollen. Blood is drawn to test for rheumatoid factor and antinuclear antibody. Synovial fluid is aspirated and analyzed. Results from analysis of the synovial fluid rule out crystal deposition diseases, such as gout and pseudogout, and no infectious microorganisms are seen.
Results of immunologic blood tests are as follows:
Rheumatoid factor (RF): Positive
Antinuclear antibody (ANA): Negative
Critical Thinking Questions
1. Do the patient’s clinical symptoms and laboratory results support a diagnosis?
2. If so, what diagnosis would be the first choice, and why?
Homework Answers
Answer: The patient's symptoms includes pain in joints as well as swelling and the laboratory results reveal about the drying of the synovial fluid and crystal formation. These are the conditions which indicate the presence of rheumatoid arthritis.
The on of the diagnosis of choice is the blood test which shows the drying of synovial fluid and the antianti-cyclic citrullinated peptide (anti-CCP) antibodies.This causes wear and tear in the joints. Hence it reveals about the diseased conditions.
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