Case of the Month February 2014

Submitted by Louis Muscarella, MD

A 65-year-old male presents with chronic right wrist pain that started at least 5 months ago. The pain which he describes as "achy" is a 1-10 at baseline and becomes 6-10 with movement. The patient does not recall any episodes of trauma.  On physical exam, there is tenderness of the right wrist that is most significant on the radial aspect and decreased range of motion.  

For a full-size image, please click X-ray of wrist 1 .

1- What diagnosis is most likely given the constellation of radiographic findings above?
A- Osteoarthritis
B- Rheumatoid arthritis
C- Gout
D- Lupus

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