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Behçet disease — SCE Rheumatology MCQ

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HardVasculitisBehçet diseaseSCE Rheumatology

A 74-year-old man has recurrent oral ulcers, genital ulcers and painful red eyes. Examination shows papulopustular lesions and a positive pathergy test are present. Investigations show HLA-B51 is positive. The admitting team asks which diagnosis best explains the whole presentation. What is the most likely diagnosis?

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Correct answer: D — Behçet disease

Behçet disease is the best answer because the pattern described is most consistent with Behçet disease, including the distribution of symptoms and the targeted investigation results. Osteomalacia is a plausible distractor, but it does not account for the key discriminator in the stem. CPP crystal arthritis and SLE would be more appropriate in a different clinical pattern or at another point in the pathway, while Hydroxychloroquine retinopathy 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 GCA guideline; EULAR ANCA-associated vasculitis recommendations; BNF