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A 55-year old woman presents with symmetric stiffness and swelling of the proximal interphalangeal joints of the hands and of the metacarpopharyngeal joints, as well as fatigue, malaise, and myalgia. Symptoms are worse in the morning or after extended inactivity and improve with movement and use throughout the day. Ulna deviation of the fingers symmetrically on both hands is noted. Which of the following is the most likely etiology of this condition?

A) Mechanical injury (Wear and Tear)
B) Autoimmune disease
C) Urate Crystal Deposition
D) X-linked dominant

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