Viral arthritis — SCE Rheumatology MCQ

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EasyRheumatoid arthritisViral arthritisSCE Rheumatology

A 74-year-old woman develops acute symmetrical small-joint pain after a febrile illness. Examination shows there is mild synovitis without erosions. Investigations show parvovirus B19 IgM 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: B — Viral arthritis

Viral arthritis is the best answer because the pattern described is most consistent with Viral arthritis, including the distribution of symptoms and the targeted investigation results. Anti-CCP positive rheumatoid arthritis is a plausible distractor, but it does not account for the key discriminator in the stem. Hydroxychloroquine retinopathy and Reactive arthritis would be more appropriate in a different clinical pattern or at another point in the pathway, while Gout 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 NG100; BSR biologic/targeted DMARD safety guideline; BNF