A 43-Year-Old Man Comes to the Physician Reporting Acute-Onset Right

A 43-year-old man comes to the physician reporting acute-onset right knee pain.  He was diagnosed with diabetes mellitus a year ago and takes metformin.  He does not use tobacco, alcohol, or illicit drugs.  The patient is in a monogamous relationship.  His father also has diabetes.  His temperature is 37 C (98.6 F) , blood pressure is 134/86 mm Hg, pulse is 86/min, and respirations are 16/min.  BMI is 26 kg/m².  Physical examination shows a slightly swollen and tender right knee and mild hepatomegaly.  Right knee x-ray reveals chondrocalcinosis and a moderate effusion.  Appropriate analgesic is administered for joint pain.  Which of the following is the best next step in management of this patient?

A) Anticitrullinated peptide antibodies
B) Antismooth muscle antibodies
C) Liver biopsy
D) Serum iron studies
E) Serum uric acid level
F) Slit-lamp eye examination

Correct Answer:

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