skip to main content

Oligoarticular juvenile idiopathic arthritis — SCE Rheumatology MCQ

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

ModeratePaediatric rheumatologyOligoarticular juvenile idiopathic arthritisSCE Rheumatology

A 52-year-old woman has painless knee swelling for 8 weeks. Examination shows one knee is warm with reduced extension. Investigations show ANA is positive and inflammatory markers are modestly raised. The diagnosis is established and symptoms remain clinically important despite initial supportive measures. There is no contraindication to disease-modifying or anti-inflammatory escalation. What is the most appropriate management?

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

Reveal the answer and explanation

Correct answer: C — Intra-articular corticosteroid

Intra-articular corticosteroid injection is the best answer because intra-articular corticosteroid injection is the most appropriate next step for oligoarticular juvenile idiopathic arthritis in this clinical setting. IL-1 inhibitor therapy is a plausible distractor, but it does not account for the key discriminator in the stem. Methotrexate and Hydroxychloroquine would be more appropriate in a different clinical pattern or at another point in the pathway, while Urgent antibiotics is suboptimal for this presentation. Clinical pearl: rheumatology management is generally treat-to-target, but infection risk, pregnancy plans and shared-care monitoring often determine the safest answer.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/musculoskeletal-conditions