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Axial spondyloarthritis with recurrent uveitis — SCE Rheumatology MCQ

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ModerateSpondyloarthropathiesAxial spondyloarthritis with recurrent uveitisSCE Rheumatology

A 78-year-old man has active axial spondyloarthritis, BASDAI 6.4 despite two NSAIDs and recurrent acute anterior uveitis. What is the most important complication to screen for?

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

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Correct answer: BVisual loss from recurrent anterior uveitis

Visual loss from recurrent anterior uveitis is the single best answer because active axial disease plus recurrent uveitis favours a monoclonal anti-TNF. The stem is testing complication screening, not isolated recall, so the relevant clinical pattern and risk context determine the answer. Mechanical back pain is less suitable because it fits a different clinical pattern or a different treatment threshold; Rheumatoid arthritis, Methotrexate for isolated axial symptoms and Rituximab 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 NG65; BSR psoriatic arthritis and axial spondyloarthritis guidance