A 61-Year-Old Immigrant to the United States Has a Long

A 61-year-old immigrant to the United States has a long history of "joint problems." She began experiencing hand pain at the age of 30, and her symptoms have been intermittent but progressive since then. When the pain was severe, nonsteroidal anti-inflammatory drugs were used to treat the symptoms. In addition, the patient has a history of hypertension and chronic anemia. She does not consume alcoholic beverages or illegal drugs. Family history is unimportant. On examination, both hands show severe deformity of multiple joints. The image below depicts the X-ray findings. The disease process responsible for the radiographic findings would most likely affect which of the following?

A) Cervical spine
B) Lumbar spine
C) Sacroiliac joints
D) Thoracic spine

Correct Answer:

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