Patient is 58-year-old white female who presented to her physician's office a week earlier complaining of pain in the finger joints of both hands. She stated her hands and fingers were stiff, swollen, and she had significant pain. She had been trying to manage the pain with over-the-counter NSAIDs, but felt like, "I'm losing the battle." Her physician ordered x-rays of her hands and a variety of

blood work, including ANA, ESR, and CRP tests. She returned to the office for the results of her tests.

On physical exam today, not much has changed in her hands. They are both swollen and very stiff. She rates the pain in her hands as an 8 of 10. Her physician told her that the blood work was positive for rheumatoid arthritis. The x-rays showed swelling of the soft tissues and early signs of erosions in the proximal interphalangeal joints.

First-listed diagnosis: ________________
Fill in the blank with correct word.

Treatment options were reviewed, and based on the patient's preference; she was referred to a rheumatologist for further treatment. A prescription for pain medication was given to the patient, and the referral for the rheumatologist was completed.

Dx: Rheumatoid arthritis

Answer: Rheumatoid arthritis – right hand – M06.841; Rheumatoid arthritis – left hand – M06.842

Secondary diagnoses: Answer: None