11th January 2024

A 68-year-old man presents to his GP with progressive shortness of breath on exertion.

A 68-year-old man presents to his GP with progressive shortness of breath on exertion. His only past medical history is hypertension and total hip replacement 5 years ago; he also had an MI 3 years ago, which was managed medically. He used to be a construction worker re-decorating old properties – retired 15 years ago. On examination, he has hard bony swellings in PIPs and DIPs of the fingers. There are lower zone coarse crackles, and chest x-ray shows bibasal lung changes. What is the most likely diagnosis?

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