18th January 2024

A 45-year-old patient is reviewed in clinic with severe dysphagia.

A 45-year-old patient is reviewed in clinic with severe dysphagia. You notice multiple white-coloured palpable nodules on her fingers. She is complaining of progressive breathlessness over the last year to the point where she can hardly mobilise around her house. 

Which of the following clinical signs would you least expect to see?

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