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Steroid Injection Tendinopathy — SCE Rheumatology MCQ

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HardSoft Tissue RheumatologySteroid Injection TendinopathySCE Rheumatology

A patient has six aspiration-proven acute CPP crystal arthritis attacks in 9 months. There is no infection, haemochromatosis or hyperparathyroidism; renal function is normal and attacks resolve completely between episodes. Which preventive option is supported by EULAR?

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Correct answer: A — Low-dose colchicine 0.5–1 mg daily after interaction review

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

C is correct. EULAR allows low-dose colchicine 0.5–1 mg daily, or an NSAID with gastroprotection when appropriate, for recurrent acute CPP arthritis. A treats urate deposition rather than CPP crystals. B exposes the patient to disproportionate long-term steroid toxicity. D is not routine first-line CPPD prophylaxis. E may be considered only in selected chronic inflammatory CPPD, not before simpler recurrent-flare prevention.

Reference: EULAR recommendations for management of CPPD: https://ard.bmj.com/content/70/4/571