Question

A 41-year-old woman presents with symmetrical pain and stiffness in the small joints of her hands and feet for 4 months, worst in the morning lasting over an hour. Examination shows synovitis of MCP and PIP joints bilaterally. What is the most appropriate initial disease-modifying treatment?

Accepted Answer

Start Methotrexate once weekly with folic acid supplementation.

Answer

Start Paracetamol alone as required.

Answer

Start long-term oral Prednisolone monotherapy.

Answer

Start Colchicine 500 micrograms twice daily.

Answer

Start high-dose NSAIDs alone for long-term control.

Practice question

A 41-year-old woman presents with symmetrical pain and stiffness in the small joints of her hands and feet for 4 months, worst in the morning lasting over an hour. Examination shows synovitis of MCP and PIP joints bilaterally. What is the most appropriate initial disease-modifying treatment?