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Question category: Rheumatology

A 62 year old presents with pain and swelling of her carpal metacarpal and distal interphalangeal joints. X-rays are performed and shows erosions of a gull’s wing pattern. There is no osteophytes or Juxta-articular osteopaenia. Although ESR is slightly elevated, rheumatoid factor and all other autoantibodies are negative. What is the most likely diagnosis?

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