Axial spondyloarthritis — SCE Rheumatology MCQ
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Correct answer: A — MRI sacroiliac joints and inflammatory markers
The best answer is “MRI sacroiliac joints and inflammatory markers”. MRI sacroiliac joints and inflammatory markers most directly resolves the diagnostic or staging uncertainty at this point in the pathway; the other investigations answer different questions or have lower yield. The remaining choices—“Routine lumbar ultrasound, after safety review”, “CT abdomen for renal stones”, “No investigation because sport improves symptoms”, “Shoulder radiographs, after safety review”—are credible in related rheumatology presentations, but each addresses a different diagnosis, investigation, treatment sequence or complication and does not fit the decisive findings in this stem.
Reference: British Society for Rheumatology clinical guidelines: https://academic.oup.com/rheumatology/pages/clinical-guidelines