A 48-year-old woman presents with symmetrical swelling and pain of the small joints of the hands for 8 weeks, with early morning stiffness of 1 hour. ...

Question

A 48-year-old woman presents with symmetrical swelling and pain of the small joints of the hands for 8 weeks, with early morning stiffness of 1 hour. ESR is raised and rheumatoid factor is positive. What is the most appropriate management?

Accepted Answer

Refer urgently to rheumatology for early DMARD initiation such as Methotrexate

Answer

Start high-dose NSAIDs long-term only

Answer

Wait for 6 months before referral to confirm persistence

Answer

Treat with opioids only

Answer

Start long-term steroids without specialist input

uk-plab-1 MCQ (SBA): Rheumatoid arthritis

A 48-year-old woman presents with symmetrical swelling and pain of the small joints of the hands for 8 weeks, with early morning stiffness of 1 hour. ESR is raised and rheumatoid factor is positive. What is the most appropriate management?