A 30-year-old woman presents with swelling and pain of multiple small joints of the hands and morning stiffness lasting more than 1 hour. Rheumatoid f...

Question

A 30-year-old woman presents with swelling and pain of multiple small joints of the hands and morning stiffness lasting more than 1 hour. Rheumatoid factor is positive and ultrasound confirms synovitis. She is awaiting rheumatology review. What is the most appropriate initial management in primary care?

Accepted Answer

Refer urgently and offer short course of low-dose oral Prednisolone if needed for symptom control

Answer

Start long-term oral Prednisolone 20 mg daily

Answer

Start NSAIDs only and wait for specialist review

Answer

Start Methotrexate immediately in primary care

Answer

Reassure and review in 6 months

uk-plab-1 MCQ (SBA): Early rheumatoid arthritis