A 43-year-old woman has 4 months of symmetric swelling and pain in the MCP and PIP joints with morning stiffness lasting 2 hours. Rheumatoid factor

Question

A 43-year-old woman has 4 months of symmetric swelling and pain in the MCP and PIP joints with morning stiffness lasting 2 hours. Rheumatoid factor and anti-CCP antibodies are positive. Hand radiographs show early erosions. Which of the following is the most appropriate next step in management?

Accepted Answer

Start disease-modifying antirheumatic therapy

Answer

Schedule joint replacement first

Answer

Treat with topical antifungal cream

Answer

Delay treatment until deformities occur

Answer

Use opioid monotherapy as long-term treatment

Rheumatoid arthritis — USMLE Step 3 MCQ

A 43-year-old woman has 4 months of symmetric swelling and pain in the MCP and PIP joints with morning stiffness lasting 2 hours. Rheumatoid factor and anti-CCP antibodies are positive. Hand radiographs show early erosions. Which of the following is the most appropriate next step in management?