Question

A 50-year-old woman presents with progressive bilateral hand stiffness and pain, worse in the morning for over an hour, improving with activity. Examination shows MCP and PIP joint swelling bilaterally. What is the MOST appropriate initial disease-modifying therapy?

Accepted Answer

Refer to rheumatology and commence methotrexate after baseline investigations

Answer

Paracetamol as needed only

Answer

Start a non-steroidal anti-inflammatory drug long term

Answer

Start long-term oral prednisolone 20 mg daily

Answer

Begin hydroxychloroquine monotherapy and no further follow-up

Practice question

A 50-year-old woman presents with progressive bilateral hand stiffness and pain, worse in the morning for over an hour, improving with activity. Examination shows MCP and PIP joint swelling bilaterally. What is the MOST appropriate initial disease-modifying therapy?