Abstract
The case: Three months after an uncomplicated pregnancy and delivery Mrs. D consults her physician about new pain and swelling in her wrists and several proximal interphalangeal joints; 1 wrist is swollen and tender and there is tenderness in the ring metacarpalphalangeal (MCP) and 2 proximal interphalangeal (PIP) joints of each hand. She has morning stiffness which lasts 30 minutes There has been no recent infection or triggering event, and she has no history of a similar problem. Mrs. D has been trying to ignore these symptoms for the last 6 weeks, but she is having difficulty lifting and changing her baby.