[Answered]: A 66-year-old, right-handed white man, seeks…

A 66-year-old, right-handed white man, seeks treatment for swelling and decreased range of motion in the third finger of his right hand. He tells you he retired at age 65 after 40 years of assembly-line work. He reports that his physical activity has decreased and his weight has increased 20 lbs since retiring. His hobbies include woodworking and playing cards. Although he describes several years of joint pain that gradually worsened, his activities were not limited until 6 months ago when he noted an insidious onset of swelling in the right third DIP joint. Over the years, he has sporadically taken acetaminophen, aspirin, and ibuprofen to control the pain. He reports that none of the drugs provided better relief than others. He is concerned that he will continue to lose movement in the finger already affected, as well as in the fingers of his left hand. His medical history is remarkable for hypertension and three episodes of gout.