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Reactive arthritis — SCE Rheumatology MCQ

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EasySpondyloarthropathiesReactive arthritisSCE Rheumatology

A 42-year-old woman develops asymmetric oligoarthritis 3 weeks after dysuria. Examination shows there is enthesitis and conjunctival injection. Investigations show rheumatoid factor is negative and urine NAAT confirms chlamydia. The admitting team asks which diagnosis best explains the whole presentation. What is the most likely diagnosis?

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Correct answer: C — Reactive arthritis

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