A 45-year-old woman presents with pain and swelling of the small joints of both hands and morning stiffness lasting over 1 hour. Rheumatoid factor is ...

Question

A 45-year-old woman presents with pain and swelling of the small joints of both hands and morning stiffness lasting over 1 hour. Rheumatoid factor is positive and ultrasound shows synovitis. What is the most appropriate initial disease-modifying treatment?

Accepted Answer

Start Methotrexate and refer to rheumatology

Answer

Start long-term oral Prednisolone alone

Answer

Use NSAIDs only for long-term control

Answer

Start Allopurinol

Answer

No treatment until erosions develop on X-ray

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

A 45-year-old woman presents with pain and swelling of the small joints of both hands and morning stiffness lasting over 1 hour. Rheumatoid factor is positive and ultrasound shows synovitis. What is the most appropriate initial disease-modifying treatment?