Woman With Hand Pain and Swelling

A 37-year-old woman with no medical history presented with 4 days of atraumatic pain, erythema, and swelling overlying the palmar aspect of her left small-finger metacarpal-phalangeal joint (Figure 1). Range of motion of the metacarpal-phalangeal joint was severely limited by pain. This had worsened despite 48 hours of antibiotic treatment. Her vital signs were normal. White blood cell count was 10.8×103/μL. C-reactive protein level was elevated, at 16.4 mg/L. Ultrasonography showed a metacarpal-phalangeal joint effusion and calcification (Figure 2).

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