Florence (62 years old)

Florence is a 62-year-old woman who works as a secretary. She has a BMI of 32, is right-hand dominant, and has a past medical history of gastritis.

During a telephone consultation, she reports increasing pain, swelling and stiffness affecting multiple fingers in both hands. This is now affecting her work as she is finding it more difficult to type on the computer. Although she has no morning stiffness, her hands feel increasingly stiff and sore throughout the course of the day. She would like to know what is causing her symptoms. She is currently at work in an office over 1-hour drive away, but she does live locally and can reach your clinic in case of need.