SLE flare — SCE Rheumatology MCQ

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EasyMusculoskeletal investigationsSLE flareSCE Rheumatology

A 47-year-old woman has SLE with fatigue, rash and new inflammatory arthralgia. Examination shows there is mild synovitis and oral ulceration. Investigations show complement is low and anti-dsDNA has risen. The admitting team asks which diagnosis best explains the whole presentation. What is the most likely diagnosis?

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Correct answer: B — SLE flare

SLE flare is the best answer because the pattern described is most consistent with SLE flare, including the distribution of symptoms and the targeted investigation results. ANCA-associated vasculitis is a plausible distractor, but it does not account for the key discriminator in the stem. Polymyalgia rheumatica and Gout would be more appropriate in a different clinical pattern or at another point in the pathway, while Neonatal lupus risk is suboptimal for this presentation. Clinical pearl: in SCE-style questions, the decisive clue is usually the pattern across joints, extra-articular features and targeted immunology rather than a single antibody result.

Reference: BSR hot swollen joint guideline; NICE NG100; EULAR imaging recommendations