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- The radiographs show diffusely decreased bone density in the hand of a 40-year-old woman, with multiple subluxed MCP and IP joints and dislocation of the 5th PIP joint that is nearly reduced on the PA view. No erosions or productive changes are seen. - The most likely diagnosis is rheumatoid arthritis given the diffuse decreased bone density, subluxations, and dislocations seen which are characteristic of rheumatoid arthritis. Gout, SLE, scleroderma, and erosive osteoarthritis are less likely given the lack of findings more characteristic of those conditions such as erosions or productive changes.














