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Eosinophilic fasciitis — SCE Rheumatology MCQ

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HardConnective tissue diseasesEosinophilic fasciitisSCE Rheumatology

A 44-year-old woman develops painful swelling and woody induration of both forearms after starting a new intense exercise programme. Fingers are spared, Raynaud's is absent, ANA is negative and eosinophils are 1.8 × 10^9/L. MRI shows fascial thickening and biopsy confirms inflammatory fascial infiltrate. What is the most likely diagnosis?

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Correct answer: B — Eosinophilic fasciitis

Eosinophilic fasciitis causes painful limb induration with fascial inflammation, often sparing fingers and lacking Raynaud's. Diffuse systemic sclerosis usually involves Raynaud's, sclerodactyly and internal organ screening concerns. MRI and deep biopsy are useful when the clinical picture is uncertain.

Reference: BSR rheumatology curriculum; EULAR systemic sclerosis recommendations