[Expert Solution]: HPI: GG is a 61-year-old female who presents…

HPI: GG is a 61-year-old female who presents to her PCP due to feeling fatigued over the past three months and having pain, stiffness, and edema in multiple joints. She reports sleeping at least nine hours per day and often naps after she gets home from work, but still feels tired. The location of joint pain varies. At times it is in her hands and other times in her wrist, shoulders, or needs. She reports that she feels stiff in the morning, but the stiffness improves throughout the day. She’s tried acetaminophen and ibuprofen for joint pain but gets minimal relief, so she stopped taking both of these medications. PMH: no significant history FH/SH: Lives alone, non-smoker, no alcohol or illicit drug use. She is a research assistant at the local university. Does not follow a particular diet, she tried the paleo diet, but now tries to minimize fats and carbohydrates. She often works late and does not regularly exercise. Her parents alive; mother with HTN, father with BPH, HTN. She has no siblings. Meds: none ROS: As above. Denies history of cardiac or pulmonary disease. VS: BP 125/80, RR 17 non-labored, P 80, T 99.6; Height 5’6”; Weight 140 lbs. Exam unremarkable except as follows: moves all extremities. Swelling of the 3rd, 4th, and 5th PIP joints bilaterally, 4th and 5th MCP joints are tender to palpation bilaterally, she has poor grip strength bilaterally. On exam she has tenderness to palpation and decreased range of motion bilaterally to her shoulders, tenderness to palpation and mild edema noted to bilateral knees with minimally decreased range of motion. Labs and diagnostics: none previously ordered Questions 1) What is your top differential diagnosis? Please explain and justify your choice. (10 pts) 2) What are three other diagnoses that you could consider? Please justify your response. (20 pts) 3) How would you work up this patient (labs, diagnostic tests) to confirm your top differential diagnosis? (20 pts)