Basic calcium phosphate disease — SCE Rheumatology MCQ

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EasyCrystal arthropathiesBasic calcium phosphate diseaseSCE Rheumatology

A 58-year-old woman has acute shoulder pain with calcific deposits near the rotator cuff. Examination shows abduction is painful and limited. Investigations show radiographs show periarticular calcification. The admitting team asks which diagnosis best explains the whole presentation. What is the most likely diagnosis?

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Correct answer: A — Basic calcium phosphate disease

Basic calcium phosphate disease is the best answer because the pattern described is most consistent with Basic calcium phosphate disease, including the distribution of symptoms and the targeted investigation results. Osteoarthritis is a plausible distractor, but it does not account for the key discriminator in the stem. Rheumatoid arthritis and Psoriatic 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: NICE NG219; BSR hot swollen joint guideline; EULAR crystal arthropathy recommendations