Thirty-five-year-old Mrs Morris was referred to a rheumatology clinic by her GP, with stiffness in her fingers and wrists. Prior to her first pregnancy two years earlier, she had experienced similar symptoms, but these had receded at conception. Since the birth of her child she had found it progressively more awkward to carry out tasks involving fine finger coordination. The symptoms were worse in the mornings, although her hands felt clumsy throughout the day. She also experienced a tingling sensation in her thumb and first two fingers of each hand.
The results of initial laboratory investigations are shown below:
Initial investigation at Rheumatology Clinic
X-ray of hands Erosion at the distal radii and metacarpophalangeal joints
Questions:
a) What condition do you think this woman is suffering from and why? Refer to the evidence presented in the case study and laboratory result.
b) Explain what the laboratory results mean and how they can deduce a diagnosis .
c) Discuss the role of the immune system and the possible immune mechanisms involved in this condition.
