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Erosive Inflammatory OA — SCE Rheumatology MCQ

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HardOsteoarthritisErosive Inflammatory OASCE Rheumatology

A patient has chronic CPP crystal inflammatory arthritis of both wrists and MCP joints after septic arthritis and rheumatoid arthritis have been excluded. Intermittent aspiration and injections no longer control symptoms. Which oral strategy is supported by EULAR?

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Correct answer: C — Use low-dose colchicine or NSAID; consider hydroxychloroquine or methotrexate if persistent

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

C is correct. EULAR supports NSAID with gastroprotection and/or low-dose colchicine for chronic CPP inflammatory arthritis, with low-dose glucocorticoid, hydroxychloroquine or methotrexate considered in persistent disease. A and B target urate rather than CPP crystals. D mistakes distribution for infection after appropriate exclusion. E has no established crystal-clearing or disease-modifying role.

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