Question

A 50-year-old woman presents with 3 months of symmetrical pain and swelling in the small joints of the hands and morning stiffness of 90 minutes. ESR and CRP are elevated; rheumatoid factor and anti-CCP antibodies are positive. What is the most appropriate management?

Accepted Answer

Early referral to rheumatology and commence disease-modifying antirheumatic drug such as methotrexate

Answer

Start long-term NSAIDs only

Answer

Use corticosteroids alone for long-term control

Answer

Reassure and observe for 12 months

Answer

Treat with opioids for pain

Practice question

A 50-year-old woman presents with 3 months of symmetrical pain and swelling in the small joints of the hands and morning stiffness of 90 minutes. ESR and CRP are elevated; rheumatoid factor and anti-CCP antibodies are positive. What is the most appropriate management?