A 77-year-old woman presented to a clinic with a 2-year history of slowly progressive, painful swelling of her fingertips. Physical examination of the hands showed thickening of the skin on her right hand as well as soft-tissue swelling of the tips of the fingers of both hands. A plain radiograph of the hands is shown. What is the most likely diagnosis? A) Tophaceous gout B) Calcinosis C) Metastatic chondrosarcoma D) Vitamin D toxicity E) Myositis ossificans

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Answer B CREST Syndrome Calcinosis, Raynaud's, Esophageal motility disorders, Scleroderma and Telangiectasias - CREST syndrome. In this syndrome, the hands are affected by calcinosis, Raynaud's and scleroderma.

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B. Calcinosis.

Rheumatoid Artthritis

B. Calcinosis

2 ..CALCI....

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B) Calcinosis

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C metastatic chondrosarcoma

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B.Calcinosis

B, calcinosis

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