Jason is referred to physical therapy for gradually progressive bilateral hand pain and stiffness. The patient reports that the hands feel stiff for approximately 15 minutes after waking and becomes increasingly painful after prolonged gripping and household activities. Examination reveals firm enlargement of several interphalangeal joints and decreased motion of the first carpometacarpal joints bilaterally. There is no significant warmth or swelling of the metacarpophalangeal joints.
Which of the following additional findings would be MOST likely in this patient?
A) Ulnar drift of the digits at the metacarpophalangeal joints
B) Swan-neck deformity involving hyperextension of the PIP joints
C) Heberden nodes involving the distal interphalangeal joints
D) Boutonnière deformity involving flexion of the PIP joints
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