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Enteropathic arthritis — SCE Rheumatology MCQ

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EasySpondyloarthropathiesEnteropathic arthritisSCE Rheumatology

A 52-year-old woman has inflammatory back pain with diarrhoea and weight loss. Examination shows sacroiliac tenderness and peripheral ankle synovitis are present. Investigations show faecal calprotectin is raised. The admitting team asks which diagnosis best explains the whole presentation. What is the most likely diagnosis?

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Correct answer: E — Enteropathic arthritis

Enteropathic arthritis is the best answer because the pattern described is most consistent with Enteropathic arthritis, including the distribution of symptoms and the targeted investigation results. Granulomatosis with polyangiitis is a plausible distractor, but it does not account for the key discriminator in the stem. Enthesitis-related arthritis and Paget disease of bone would be more appropriate in a different clinical pattern or at another point in the pathway, while Mechanical low back pain 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: NICE NG65; EULAR/ASAS axial spondyloarthritis recommendations; BNF