Pathophysiologic mechanism of chronic hand joint pain in an older adult

A 62-year-old woman presents to her primary care physician with a several-year history of progressively worsening pain in her hands that is worse at the end of the day and improves with rest. She reports mild morning stiffness lasting less than 15 minutes. On examination, there are bony nodules at the distal and proximal interphalangeal joints. Radiographs reveal narrowed joint spaces, subchondral sclerosis, and osteophyte formation. Which of the following pathophysiologic mechanisms best explains her condition?

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Pathophysiologic mechanism of chronic hand joint pain in an older adult | QWorld.Ai