A patient comes into the orthopedic clinic complaining of se…

A patient comes into the orthopedic clinic complaining of severe pain in his hip that was not caused by a fall. On inspection, the femur and tibia are bowed. There is also a reduced angle of the femoral neck, which gives the patient a “waddling gait” appearance. The specialist diagnoses him with Paget disease. The patient asks his NP, “how’d I get that?” The NP will respond:

 A 56-year-old woman comes to her NP for evaluation for acid…

 A 56-year-old woman comes to her NP for evaluation for acid-reflux & swallowing difficulties not improving with H2-blocker or proton pump inhibitors.  Review of symptoms endorses fatigue and dryness and “tightness” of the skin. The NP notices during her physical exam that the patient has skin tightening over the face, hands, and forearms. Telangiectasia is noted of the cheeks. Which of the following is the most likely presentation of the patient’s presentation? 

A 50-year-old woman comes to her primary care NP because of…

A 50-year-old woman comes to her primary care NP because of progressively worsening pain, stiffness, and swelling in her joints. The patient endorses morning stiffness that improves after about 2 hours. In addition, she reports generalized fatigue despite getting adequate rest each night. Serology testing is positive for antinuclear and anti-cyclic citrullinated peptide antibodies. Which of the following joint will likely be affected in this patient?