A 46-year-old woman presented to the clinic with a 3-month history of walking difficulty due to worsening knee pain

A 46-year-old woman presented to the clinic with a 3-month history of walking difficulty due to worsening knee pain. She had received a diagnosis of rheumatoid arthritis 12 years earlier but had received treatment inconsistently. On physical examination, she had nodular swelling and outward bowing of both knees. She had limited range of motion in her left shoulder and in both wrists and both knees. Anteroposterior radiograph of the knees is shown. What is the diagnosis?

    1. Synovial chondromatosis
    1. Synovial chondrosarcoma
    1. Osteochondritis dissecans
    1. Pigmented villonodular synovitis
    1. Disseminated tuberculosis

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