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Plantar fasciitis — SCE Rheumatology MCQ

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HardOsteoarthritis and soft tissue rheumatologyPlantar fasciitisSCE Rheumatology

A man has active peripheral psoriatic arthritis despite methotrexate, moderately active Crohn disease and recurrent oral candidiasis. Which advanced therapy is the most coherent first choice across these comorbidities?

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

Reveal the answer and explanation

Correct answer: B — A monoclonal TNF inhibitor such as adalimumab, selected jointly with gastroenterology

Explanation lettering: E = shown as C · C = shown as E

B is correct. A monoclonal TNF inhibitor can treat both psoriatic arthritis and Crohn disease, so adalimumab is a rational cross-specialty choice after infection assessment. A is the central trap: IL-17 inhibition can aggravate or unmask inflammatory bowel disease and is not preferred in active Crohn disease; candidiasis risk adds another concern. C incorrectly assumes etanercept treats IBD like monoclonal TNF antibodies. D overstates candidiasis as a class-wide absolute contraindication and chooses a comparatively weak joint strategy. E assigns abatacept an IBD indication it does not have. Gastroenterology input remains important because prior therapies, phenotype, perianal disease and infection history may change the final product.

Reference: 2022 BSR guideline for psoriatic arthritis with biologic and targeted synthetic DMARDs: https://academic.oup.com/rheumatology/article/61/9/e255/6594139