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CPP crystal arthritis — SCE Rheumatology MCQ

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EasyMusculoskeletal investigationsCPP crystal arthritisSCE Rheumatology

A 38-year-old woman has inflammatory musculoskeletal symptoms evolving over several weeks with features suggestive of cpp crystal 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: D — CPP crystal arthritis

CPP crystal arthritis is the best answer because the pattern described is most consistent with CPP crystal arthritis, including the distribution of symptoms and the targeted investigation results. Neonatal lupus risk is a plausible distractor, but it does not account for the key discriminator in the stem. Hydroxychloroquine retinopathy and Haemochromatosis arthropathy would be more appropriate in a different clinical pattern or at another point in the pathway, while ANCA-associated vasculitis 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