<prompt> A 35 year old female presented with MCP and PIP pain. Diagnosis:Rheumatoid ArthritisRheumatic feverGouty arthritisPsoariatic arthritis  <response>: Ans. a Rheumatoid ArthritisRef: Harrisons 18th ed. Ch. 321Clinical Features of RA Incidence of RA increases between 25 and 55 years of age. Gender: Female Male Early morning joint stiffness lasting more than 1 hour and easing with physical activity. The earliest involved joints are typically the small joints of the hands and feet. The wrists, metacarpophalangeal MCP, and proximal interphalangeal PIP joints stand out as the most frequently involved joints. Distal interphalangeal DIP joint involvement may occur in RA, but it usually is a manifestation of coexistent osteoarthritis. 