Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

• It could indicate early Felty's syndrome.
• We need to carefully palpate her abdomen looking for splenomegaly.
• If we don't find splenic enlargement, we could do an abdominal CT.
• Or we could continue to follow her once she's on aspirin and see what her white count does.

• Educate her about RA
• Start the aspirin
• Get the splints
• See how she's doing in a few weeks and recheck the CBC.