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Psoriatic arthritis — SCE Rheumatology MCQ

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EasySpondyloarthropathiesPsoriatic arthritisSCE Rheumatology

A 33-year-old man has inflammatory joint pain with heel pain and a scaly rash behind the ears. Examination shows dactylitis of one toe and nail pitting. Investigations show rheumatoid factor is negative and radiographs show juxta-articular new bone formation. 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.

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Correct answer: A — Psoriatic arthritis

Psoriatic arthritis is the best answer because the pattern described is most consistent with Psoriatic arthritis, including the distribution of symptoms and the targeted investigation results. Adhesive capsulitis is a plausible distractor, but it does not account for the key discriminator in the stem. Acute CPP crystal arthritis and Polymyalgia rheumatica would be more appropriate in a different clinical pattern or at another point in the pathway, while Paget disease of bone 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 NG65; EULAR/ASAS axial spondyloarthritis recommendations; BNF