The 38-year-old woman came to rheumatologist complaining of pain and swelling of her hands, feet, and knees. The first symptoms appeared 2 years ago. She used NSAIDs periodically, but effect is insufficient.
In the last few months, symptoms are deteriorating, she feels chronically tired, has low grade fever (37.2 - 37.5* C), 3 hour-duration morning stiffness of joints. The joints of the hands began to deform, the strength of the hands decreased, it became difficult to do normal household chores, to bend the knees, to sit down, to put on shoes.
Life history: Other diseases, allergies are denied.
Obj .: Temperature 36.9* C, skin without rash. Vital organs by examination - nothing special.
The image of the hand joints is shown in the photo:

1. What statement about joint changes in the hand are correct? (1 p.)

The 38-year-old woman came to rheumatologist complaining of pain and swelling of her hands, feet, and knees. The first symptoms appeared 2 years ago. She used NSAIDs periodically, but effect is insufficient.
In the last few months, symptoms are deteriorating, she feels chronically tired, has low grade fever (37.2 - 37.5* C), 3 hour-duration morning stiffness of joints. The joints of the hands began to deform, the strength of the hands decreased, it became difficult to do normal household chores, to bend the knees, to sit down, to put on shoes.
Life history: Other diseases, allergies are denied.
Obj .: Temperature 36.9* C, skin without rash. Vital organs by examination - nothing special.
The image of the hand joints is shown in the photo:

2. Which stament about the preliminary diagnosis is correct? (1p.)

4. The patient underwent a radiograph pf the feet.
What changes are observed on this X-ray? (1p.)