Systemic juvenile idiopathic arthritis — SCE Rheumatology MCQ
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Correct answer: E — Start IL-1 or IL-6 pathway therapy for persistent systemic inflammation
Start IL-1 or IL-6 pathway therapy for persistent systemic inflammation is the single best answer because fever, rash, arthritis and high ferritin after exclusions suggest systemic JIA. The stem is testing management choice, not isolated recall, so the relevant clinical pattern and risk context determine the answer. Growing pains is less suitable because it fits a different clinical pattern or a different treatment threshold; Septic arthritis, Check vision only if symptomatic and Belimumab 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: BSR juvenile idiopathic arthritis guidance; NICE CKS JIA; BNF