ABSTRACT
Describe your clinical findings On examination, this patient is short of breath at rest with a respiratory rate of 18 breaths/minute. She has rheumatoid arthritis of the hands, as evidenced by wasting of the small muscles of the hands, ulnar deviation and deformity of the fingers. Her fingers are also clubbed and she is cyanosed. There are several purpura on the arms suggestive of steroid use. Chest expansion is reduced. On auscultation of the chest there are bilateral, fine inspiratory crackles at both lung bases.
