Problem:
A 62-year-old carpenter presents to your clinic complaining of worsening joint pain in her hands. She states that the pain is present in all of her fingers, but is worse in the right hand and gets better when she has a few days off from work. She denies any paresthesias, fevers, or fatigue. Vital signs are normal. Physical exam reveals hard, non-tender lesions overlying the proximal interphalangeal joints of the 2nd and 3rd fingers of the right hand. All five digits of the right hand have a decreased range of motion. An X-ray of her hands is shown. What is the most likely pathogenesis