A 40-year-old woman with rheumatoid arthritis has active synovitis of wrists and MCP joints despite NSAID therapy. Rheumatoid factor and anti-CCP

Question

A 40-year-old woman with rheumatoid arthritis has active synovitis of wrists and MCP joints despite NSAID therapy. Rheumatoid factor and anti-CCP antibodies are positive. Radiographs show early erosions. She is not pregnant. Which of the following is the most appropriate next step in management?

Accepted Answer

Start methotrexate with folic acid

Answer

Use opioids as disease-modifying therapy

Answer

Delay DMARD therapy until deformities develop

Answer

Begin allopurinol

Answer

Start long-term prednisone alone

Rheumatoid arthritis — USMLE Step 3 MCQ

A 40-year-old woman with rheumatoid arthritis has active synovitis of wrists and MCP joints despite NSAID therapy. Rheumatoid factor and anti-CCP antibodies are positive. Radiographs show early erosions. She is not pregnant. Which of the following is the most appropriate next step in management?