She remembers three of three objects for you after 1 minute and after 15 minutes. Her mental status seems to be intact, but more formal testing by mini-mental status would be ideal. On physical exam, her gait and walk appear normal. She appears to be in no acute distress, but her general movement seems slow. Apical rate of 52, regular.
Lungs are clear to auscultation and percussion.
There is no tenderness. Liver, spleen, and kidneys are nonpalpable. Femoral pulses are equal. There is a sound of crepitance on passive range of motion of the patient's right shoulder and both knees. Distal finger joints are enlarged.