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A 40-year-old female presents with non-traumatic left hand pain. Patient is right-hand dominant and has no significant PMH. Pt states she is unemployed and did not do anything that could have caused this pain. On examination, her vital signs are stable and she is afebrile. She has swelling on the dorsal aspect of her hand extending toward the wrist. She has good ROM but has pain with extension and flexion of digits. No definitive cellulitis or lymphangitis is noted, although the swollen area feels warmer than the surrounding tissue. Her labs are as follows: WBC 6.8 with normal differential, ESR 14, CRP 0.8. Her hand xray was negative for acute process per radiology. You perform a focused ultrasound of the hand and note the following......
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