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Rheumatoid arthritis-associated interstitial lung disease — SCE Rheumatology MCQ

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HardInflammatory ArthritisRheumatoid arthritis-associated interstitial lung diseaseSCE Rheumatology

A 36-year-old man has seropositive rheumatoid arthritis, progressive dry cough, bibasal crackles, restrictive spirometry and reduced transfer factor. What is the most appropriate investigation?

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

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Correct answer: E — High-resolution CT chest

High-resolution CT chest is the single best answer because rheumatoid arthritis can cause clinically significant interstitial lung disease. The stem is testing investigation selection, not isolated recall, so the relevant clinical pattern and risk context determine the answer. Palindromic rheumatism is less suitable because it fits a different clinical pattern or a different treatment threshold; Erosive osteoarthritis, Hydroxychloroquine monotherapy and Etanercept 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: NICE NG100; BSR rheumatoid arthritis guideline; BNF