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Osteoarthritis flare — SCE Rheumatology MCQ

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EasyCrystal arthropathiesOsteoarthritis flareSCE Rheumatology

A 69-year-old man has inflammatory musculoskeletal symptoms evolving over several weeks with features suggestive of osteoarthritis flare. 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: C — Osteoarthritis flare

Osteoarthritis flare is the best answer because the pattern described is most consistent with Osteoarthritis flare, including the distribution of symptoms and the targeted investigation results. Systemic sclerosis is a plausible distractor, but it does not account for the key discriminator in the stem. Palindromic rheumatism and Gout would be more appropriate in a different clinical pattern or at another point in the pathway, while Osteoporosis 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