Osteomalacia — SCE Rheumatology MCQ

Correct answer: E — Replace vitamin D and correct calcium deficiency

Replace vitamin D and correct calcium deficiency is the single best answer because defective mineralisation from vitamin D deficiency causes osteomalacia. The stem is testing management choice, not isolated recall, so the relevant clinical pattern and risk context determine the answer. Osteomalacia is less suitable because it fits a different clinical pattern or a different treatment threshold; Multiple myeloma, Plain radiograph alone and Methotrexate do not address the key discriminator in this vignette. Clinical pearl: in SCE-style rheumatology questions, autoantibodies, imaging and synovial fluid findings should be interpreted with the whole phenotype.

Reference: NOGG osteoporosis guideline; NICE technology appraisals; BNF