Question

A 50-year-old woman presents with new-onset symmetrical swelling and pain of the small joints of the hands and feet for 6 weeks, with morning stiffness of 1.5 hours. According to Canadian rheumatoid arthritis guidelines, what is the appropriate initial management strategy?

Accepted Answer

Refer urgently to rheumatology and start disease-modifying anti-rheumatic drug (DMARD) therapy such as methotrexate

Answer

Start NSAIDs alone and delay referral

Answer

Use systemic corticosteroids alone long-term

Answer

Reassure and review in 6 months

Answer

Order only radiographs and delay treatment until erosions appear

Practice question

A 50-year-old woman presents with new-onset symmetrical swelling and pain of the small joints of the hands and feet for 6 weeks, with morning stiffness of 1.5 hours. According to Canadian rheumatoid arthritis guidelines, what is the appropriate initial management strategy?