A 63-year-old woman presented with a 2-year history of bilateral hand pain and stiffness that had worsened in recent months. The pain was most severe in the fingers and was associated with morning stiffness that lasted 30 minutes. There was loss of full range of motion in some finger joints.
A 51-year-old African American man with a 15-year history of chronic hepatitis C and sarcoidosis presented with persistent bilateral hand pain. The pain was aggravated by physical activity and had a waxing-and-waning pattern.
A 56-year-old man presented with a 1-week history of digital tip ulcers and ischemic gangrene. He alsoreported the recent onset of Raynaud phenomenon and diffuse joint pain.
