A 68-Year-Old Man Comes to the Office Due to Difficulty

A 68-year-old man comes to the office due to difficulty performing normal day-to-day activities with his hands.  He has had pain in his finger joints, wrists, and knees for many years and has been taking over-the-counter analgesics.  The patient has been evaluated by doctors for "joint problems" in the past but declined their treatment recommendations.  He has smoked a pack of cigarettes daily for 30 years.  Vital signs are normal.  Examination findings of the patient's hands are shown in the image below. Which of the following pathogenic mechanisms is most likely responsible for this patient's condition?

A) Calcific degeneration of the cartilage
B) Cartilage thinning and subchondral sclerosis
C) DNA/anti-DNA immune complex deposition
D) Synovial pannus formation
E) Uric acid crystal deposition

Correct Answer:

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