Vaughan-Jackson Tendon Rupture — SCE Rheumatology MCQ
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Correct answer: A — Extensor tendon rupture (Vaughan-Jackson syndrome) from attrition over eroded distal ulna requiring urgent surgical repair
The best answer is “Extensor tendon rupture (Vaughan-Jackson syndrome) from attrition over eroded distal ulna requiring urgent surgical repair”. The full clinical pattern is most consistent with Extensor tendon rupture (Vaughan-Jackson syndrome) from attrition over eroded distal ulna requiring urgent surgical repair; competing diagnoses share isolated features but not the decisive combination described. The remaining choices—“Central slip rupture, within a rheumatology pathway, within a rheumatology pathway, after safety review, after specialist assessment”, “Ulnar nerve palsy, after safety review, after safety review, after specialist assessment, with clinical reassessment”, “Carpal tunnel syndrome, with clinical reassessment, after specialist assessment, with clinical reassessment, within a rheumatology pathway”, “Trigger finger, within a rheumatology pathway, with clinical reassessment, within a rheumatology pathway, after safety review”—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: NICE NG100 rheumatoid arthritis in adults: https://www.nice.org.uk/guidance/ng100/chapter/Recommendations