mRSS Scoring — SCE Rheumatology MCQ

Correct answer: A — Skin thickness by palpation at 17 body sites, each scored from 0 to 3, after specialist assessment, within a rheumatology pathway

The best answer is “Skin thickness by palpation at 17 body sites, each scored from 0 to 3, after specialist assessment, within a rheumatology pathway”. The modified Rodnan skin score grades palpated skin thickness from 0 to 3 at 17 body sites, producing a total from 0 to 51 for longitudinal assessment of cutaneous involvement. The remaining choices—“Digital-ulcer burden at 10 sites, each scored from 0 to 5, within a rheumatology pathway, with clinical reassessment, after safety review”, “Nailfold-capillary density at 17 sites, after safety review, after specialist assessment, within a rheumatology pathway, after specialist assessment”, “Proximal muscle power using a 0-to-5 scale, after specialist assessment, with clinical reassessment, after safety review, with clinical reassessment”, “Pulmonary fibrosis severity on high-resolution CT, with clinical reassessment, within a rheumatology pathway, after specialist assessment, within a rheumatology pathway”—are credible in related rheumatology presentations, but each addresses a different diagnosis, investigation, treatment sequence or complication and does not fit the decisive findings in this stem.

Reference: BSR 2024 systemic sclerosis guideline: https://pmc.ncbi.nlm.nih.gov/articles/PMC11534099/