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Dactylitis Pathology — SCE Rheumatology MCQ

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HardSpondyloarthropathyDactylitis PathologySCE Rheumatology

A patient has newly diagnosed systemic-sclerosis-associated ILD. Baseline HRCT and gas-transfer testing are complete, and treatment has started. How often should PFTs usually be repeated during the first 3–5 years?

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

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Correct answer: B — Repeat PFTs at 3–6-month intervals during this phase

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

A is correct. BSR recommends PFTs every three to six months in recently diagnosed SSc-ILD during the first three to five years, when progression risk is greatest. After that, six- to twelve-month intervals can be considered. Symptoms and resting oxygen saturation can lag behind FVC or gas-transfer decline, and serial HRCT is not a substitute for physiology. HRCT is repeated for worsening symptoms or PFTs, alternative diagnoses, or selected baseline comparison rather than at every monitoring visit.

Reference: BSR 2024 guideline for management of systemic sclerosis: https://academic.oup.com/rheumatology/article/63/11/2956/7750184