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Anti-U1 RNP overlap disease — SCE Rheumatology MCQ

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ModerateMusculoskeletal InvestigationsAnti-U1 RNP overlap diseaseSCE Rheumatology

A 72-year-old woman has Raynaud's, swollen fingers, synovitis, mild myositis and strongly positive anti-U1 RNP antibodies. What is the most likely diagnosis?

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

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Correct answer: D — Mixed connective tissue disease

Mixed connective tissue disease is the single best answer because anti-U1 RNP with overlap features supports mixed connective tissue disease. The stem is testing diagnostic synthesis, not isolated recall, so the relevant clinical pattern and risk context determine the answer. Rheumatoid arthritis is less suitable because it fits a different clinical pattern or a different treatment threshold; Systemic lupus erythematosus, Psoriatic arthritis and Gout 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 hot swollen joint guidance; EULAR imaging/autoantibody recommendations