A 49-year-old woman presents with 6 months of symmetric pain and morning stiffness of the small joints of the hands and wrists lasting 1 hour, with s...

Question

A 49-year-old woman presents with 6 months of symmetric pain and morning stiffness of the small joints of the hands and wrists lasting >1 hour, with swelling on examination. ESR is elevated and RF is positive. According to Canadian Rheumatology Association guidance, what is the most appropriate next step?

Accepted Answer

Refer urgently to rheumatology for early initiation of DMARD therapy such as methotrexate

Answer

Start long-term NSAIDs only

Answer

Wait 6 months to see if symptoms resolve

Answer

Start low-dose prednisone only and defer DMARDs

Answer

Treat with glucosamine and chondroitin

ca-mccqe1 MCQ (SBA): Early rheumatoid arthritis management