Mr. Choenyi is a 39-year-old man who recently emigrated to the United States from Tibet. During a visit to his physician, he reported a history of bilateral knee and ankle pain. Magnetic resonance imaging (MRI) showed deformities of his knee joints and narrowed joint spaces in both ankles. Given his medical history, country of origin, and radiographic findings, his physician suspects _______.

Question

Multiple Choice

hereditary hemochromatosis

Wilson disease

Keshan disease

Kashin-Beck disease

Answer 1

Given Mr. Choenyi's symptoms, medical history, country of origin, and radiographic findings, his physician likely suspects Kashin-Beck disease.

Kashin-Beck disease is a form of osteoarthropathy that primarily affects the joints and can lead to deformities and narrowing of joint spaces, as seen in Mr. Choenyi's MRI findings. This condition is associated with selenium deficiency, which is prevalent in certain regions, including some parts of Tibet.

While hereditary hemochromatosis and Wilson’s disease can also affect the joints, they do not have a direct association with Tibetan culture or selenium deficiency. Keshan disease is primarily related to heart issues and is also associated with selenium deficiency, but it does not present with joint deformities as prominently as Kashin-Beck disease does.

Therefore, the most likely suspicion based on the given information is Kashin-Beck disease.