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?AStart high-dose NSAIDs long-term onlyBRefer urgently to rheumatology for early DMARD initiation such as MethotrexateCWait for 6 months before referral to confirm persistenceDTreat with opioids onlyEStart long-term steroids without specialist inputCheck my answer