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Introduction. Interactive format Clinical featuresLaboratory featuresExtra-articular featuresManagement considerations and paradigmsPrognosis. Case Presentation:55 YOF complains of months of bilateral hand pain. She describes progressive morning stiffness lasting 3 hours with wrist, MCP, and PIP pain and swelling. She has also noted some discomfort and perhaps swelling in her wrists, shoulders, knees, and toes. Review of systems is unremarkable. Wh9451

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