26th February 2025

A 25-year-old female is referred by her general practitioner after being seen with occasional hand arthralgia and a positive ANA of 1:80.

A 25-year-old female is referred by her general practitioner after being seen with occasional hand arthralgia and a positive ANA of 1:80. You see her in rheumatology clinic and perform a thorough history and examination. She denies any history of skin rash, photosensitivity, mouth ulcers or hair loss. She works as a classical pianist and finds her hand pain can get worse towards the end of the day when she has been practising. She has no past medical history and takes no regular medications.

On examination she has no evidence of synovitis or skin rash. Physical examination is otherwise normal.

Blood tests show the following:

Hand X-ray: no loss of joint space, no evidence of erosions. Normal hand X-ray.

Given the above information, what is the likely diagnosis?

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