skip to main content

Early RA Referral — SCE Rheumatology MCQ

Instant feedback + full explanation. One question, done properly.

HardRheumatoid ArthritisEarly RA ReferralSCE Rheumatology

A patient has 8 weeks of persistent MCP, PIP and MTP synovitis. CRP is normal and both rheumatoid factor and anti-CCP are negative. What should primary care do next?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Refer urgently to rheumatology while investigations continue

Explanation lettering: E = shown as A · A = shown as D · D = shown as E

C is correct. NICE requires urgent specialist referral for persistent small-joint or polyarticular synovitis even when acute-phase markers, RF and anti-CCP are negative. Tests ordered in primary care must not delay referral. Ultrasound confirmation and repeat serology are unnecessary gatekeepers, while empirical long-term glucocorticoid can obscure assessment and create toxicity.

Reference: NICE NG100: rheumatoid arthritis recommendations. https://www.nice.org.uk/guidance/ng100/chapter/Recommendations