Mrs. M. appears to be in good health.

Physical findings are:

• Gait is antalgic favouring the right side
• Deep tendon reflexes (DTRs) and light touch sensation intact bilaterally
• Skin is clear of rashes
• Right knee is slightly swollen having a palpable effusion and a ballotable patella
• Knee is not red or warm to touch
• Full range of motion in both knees with bilateral patellar crepitus
• Right quadriceps atrophy is noted
• Some lateral instability in the knee but no positive drawer signs
• Has hard bumps over the dorsal surface of the distal interphalangeal (DIP) joints of the second and third fingers, bilaterally
• Similar bumps present at the right fourth and fifth and the left second and fourth proximal interphalangeal joints (PIPs)
• The hips and remainder of the joint exam entirely normal.
  

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