Early RA imaging — SCE Rheumatology MCQ
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Correct answer: B — Musculoskeletal ultrasound of hands and wrists
The best answer is “Musculoskeletal ultrasound of hands and wrists”. Musculoskeletal ultrasound of hands and wrists most directly resolves the diagnostic or staging uncertainty at this point in the pathway; the other investigations answer different questions or have lower yield. The remaining choices—“CT abdomen, with clinical reassessment”, “DEXA scan, within a rheumatology pathway”, “Temporal artery ultrasound, after safety review”, “Schirmer test, after specialist assessment”—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: British Society for Rheumatology clinical guidelines: https://academic.oup.com/rheumatology/pages/clinical-guidelines