Ease Into Prep with a USMLE® Step 2 CK Question of the Day

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A 78-year-old woman comes to the physician because of pain and stiffness in her hands for 9 months. She usually has stiffness in the morning that improves after 20 minutes. Recently, she has given up knitting because it worsens the pain. She occasionally takes ibuprofen when the pain is unbearable but is generally reluctant to take medication. She has a history of psoriasis and hypertension. Current medications include a topical steroid and hydrochlorothiazide. Her blood pressure is 123/74 mm Hg. Examination is shown.

No swelling or redness of the joints is noted. She has scattered scaly patches on her arms and back. Which of the following is the most likely diagnosis?

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