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An old woman's hand with deviated fingertips

An old woman's hand with deviated fingertips

This article was originally presented as an independent educational activity under the direction of CME LLC. The ability to receive CME credits has expired. The article is now presented here for your reference. CME LLC is no longer responsible for the presentation of the article.

The Case
A 91-year-old community-dwelling woman is seen for annual physical examination. Apart from hearing loss, she has no complaints; she continues to reside alone in an assisted-living apartment, and to take care of herself.

More History/Physical
Woman who appears stated age. Vital signs, normal. Handwriting, unremarkable and not laborious. Can pick up spoon readily. Conversation a little difficult because of hearing impairment. (She won't turn on her hearing aid "because I don't want to run down the battery.")

What's Your Diagnosis?

Arthritis mutilans
Mallet finger
Osteoarthrosis
Phalangeal fracture
Rheumatoid hand

(Answer on next page.)

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