8th September 2020

A 77-year-old lady complains of chronic, symmetrical, polyarticular joint pain affecting her shoulders

A 77-year-old lady complains of chronic, symmetrical, polyarticular joint pain affecting her shoulders, wrists and knees. The pain has been going on for 4 years and is interspersed with acute bouts of pain and swelling in some of those joints. The acute episodes of pain last for 3 weeks on average and are self-limiting. Her past medical history includes hypertension and osteoarthritis. On examination, there is presence of swelling and noticeable bony deformities in the knees. Blood tests are all normal except for a raised CRP. Rheumatoid factor and anti-CCP blood tests are negative. Plain X-rays of the affected joints reveal cartilage calcifications and degenerative changes. Synovial fluid analysis suggests calcium pyrophosphate deposition disease.

For the patient above, please select the SINGLE most likely diagnosis. Select ONE option from the list above.