18th January 2024

A 35-year-old woman presented with a 3-month history of pain and swelling in her knuckles.

A 35-year-old woman presented with a 3-month history of pain and swelling in her knuckles. She had no past medical history of note. On general examination, she had a white scaly patch on her scalp. On examination of her hands, she had pain and swelling affecting the DIP joints, as well as onycholysis of most of her fingernails. 

Investigations:

RF negative 

Anti- dsDNA negative 

ENA negative 

ESR 65 mm/1st h

What is the single most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.