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单选题 周女士,头晕乏力半年,手足关节痛3年余,查体双手指肌肉萎缩,手指向尺侧偏,X线显示关节腔变窄,关节半脱位,血沉380mm/h。此患者最可能的诊断是

A、 退行性骨关节病
B、 类风湿性关节炎
C、 先天性关节畸形
D、 风湿性关节炎
E、 系统性红斑狼疮

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