skip to main content

Hydroxychloroquine retinopathy — SCE Rheumatology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateRheumatological pharmacologyHydroxychloroquine retinopathySCE Rheumatology

A 38-year-old woman has inflammatory musculoskeletal symptoms evolving over several weeks with features suggestive of hydroxychloroquine retinopathy. Examination shows there is objective synovitis or organ involvement on examination. Investigations show targeted investigations support an immune-mediated rheumatological disorder. The admitting team asks which diagnosis best explains the whole presentation. What is the most likely diagnosis?

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

Reveal the answer and explanation

Correct answer: E — Hydroxychloroquine retinopathy

Hydroxychloroquine retinopathy is the best answer because the pattern described is most consistent with Hydroxychloroquine retinopathy, including the distribution of symptoms and the targeted investigation results. IgG4-related disease is a plausible distractor, but it does not account for the key discriminator in the stem. Septic arthritis and Oligoarticular juvenile idiopathic arthritis would be more appropriate in a different clinical pattern or at another point in the pathway, while Palindromic rheumatism 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 csDMARD monitoring guideline; BSR biologic/targeted DMARD safety guideline; BNF