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RA Flare Definition — SCE Rheumatology MCQ

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HardRheumatoid ArthritisRA Flare DefinitionSCE Rheumatology

A patient with rheumatoid arthritis reports worsening joints and fatigue while receiving biological therapy, but also has fever and productive cough. What should precede DMARD escalation?

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Correct answer: C — Assess infection and confirm objective inflammatory disease activity

The best answer is “Assess infection and confirm objective inflammatory disease activity”. Infection can mimic or trigger rheumatoid symptoms and may be worsened by escalating immunosuppression, so systemic features require prompt assessment alongside examination and activity measurement. Symptoms or patient score alone do not prove a flare, delaying infection review is unsafe, and one possible infection does not mandate permanent treatment withdrawal.

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