A 67-year-old woman with long-standing rheumatoid arthritis has active synovitis in multiple joints despite maximal doses of NSAIDs. Radiographs show ...

Question

A 67-year-old woman with long-standing rheumatoid arthritis has active synovitis in multiple joints despite maximal doses of NSAIDs. Radiographs show early erosions. According to contemporary RA management principles, what is the most appropriate next step?

Accepted Answer

Start a conventional synthetic DMARD such as methotrexate

Answer

Continue NSAIDs and review in 6 months

Answer

Start low-dose oral prednisolone alone

Answer

Refer for joint replacement surgery

Answer

Treat with long-term opioids for pain

ca-mccqe1 MCQ (SBA): Rheumatoid arthritis

A 67-year-old woman with long-standing rheumatoid arthritis has active synovitis in multiple joints despite maximal doses of NSAIDs. Radiographs show early erosions. According to contemporary RA management principles, what is the most appropriate next step?