Psoriatic arthritis — SCE Rheumatology MCQ
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Correct answer: B — Musculoskeletal ultrasound with power Doppler
Musculoskeletal ultrasound with power Doppler is the single best answer because psoriasis with nail disease, dactylitis and enthesitis supports psoriatic arthritis. The stem is testing investigation selection, 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