SLE — SCE Rheumatology MCQ

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ModerateConnective tissue diseasesSLESCE Rheumatology

A 63-year-old woman has photosensitive rash, oral ulcers and migratory arthralgia. Examination shows there is synovitis without erosions. Investigations show ANA and anti-dsDNA are positive with low C3. The admitting team asks which diagnosis best explains the whole presentation. What is the most likely diagnosis?

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Correct answer: D — SLE

SLE is the best answer because the pattern described is most consistent with SLE, including the distribution of symptoms and the targeted investigation results. Oligoarticular juvenile idiopathic arthritis is a plausible distractor, but it does not account for the key discriminator in the stem. Rotator cuff tendinopathy and Hydroxychloroquine retinopathy would be more appropriate in a different clinical pattern or at another point in the pathway, while Dermatomyositis 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 SLE guideline; EULAR SLE and systemic sclerosis recommendations; BNF