A patient with painful erosive hand osteoarthritis has central erosions and inflammatory episodes at DIP and PIP joints. There is no psoriasis or

Question

A patient with painful erosive hand osteoarthritis has central erosions and inflammatory episodes at DIP and PIP joints. There is no psoriasis or synovitis outside the hands. Which disease-modifying strategy best reflects current guidance?

Accepted Answer

Use hand therapy and symptom control; do not start a DMARD

Answer

Start methotrexate because any radiographic erosion proves inflammatory arthritis

Answer

Use long-term oral prednisolone to prevent structural progression

Answer

Start hydroxychloroquine and escalate according to DAS28

Answer

Use adalimumab because erosive hand osteoarthritis is a TNF-mediated spondyloarthritis

Erosive hand osteoarthritis — SCE Rheumatology MCQ

A patient with painful erosive hand osteoarthritis has central erosions and inflammatory episodes at DIP and PIP joints. There is no psoriasis or synovitis outside the hands. Which disease-modifying strategy best reflects current guidance?