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Anti-CCP positive rheumatoid arthritis — SCE Rheumatology MCQ

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EasyMusculoskeletal investigationsAnti-CCP positive rheumatoid arthritisSCE Rheumatology

A 74-year-old woman has inflammatory musculoskeletal symptoms evolving over several weeks with features suggestive of anti-ccp positive rheumatoid arthritis. 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?

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Correct answer: B — Anti-CCP positive rheumatoid arthritis

Anti-CCP positive rheumatoid arthritis is the best answer because the pattern described is most consistent with Anti-CCP positive rheumatoid arthritis, including the distribution of symptoms and the targeted investigation results. Gout is a plausible distractor, but it does not account for the key discriminator in the stem. Primary Sjögren syndrome and Acute CPP crystal arthritis would be more appropriate in a different clinical pattern or at another point in the pathway, while CPP crystal arthritis 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