Rheumatology and Musculoskeletalcommon
A 67-year-old woman reports several years of pain at the bases of both thumbs and in the distal finger joints. The pain is worse after gardening, morning stiffness lasts 10 minutes, and examination shows firm bony enlargements at several distal interphalangeal joints without warmth. Her full blood count, C-reactive protein and erythrocyte sedimentation rate are normal. Which is the most likely diagnosis?