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HLA-B27 testing — SCE Rheumatology MCQ

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ModerateSpondyloarthropathiesHLA-B27 testingSCE Rheumatology

A 33-year-old man with axial spondyloarthritis asks whether HLA-B27 testing should be used to monitor treatment response. He has MRI-proven sacroiliitis and raised CRP before treatment. After three months of NSAIDs, symptoms improve and CRP normalises. What is the most appropriate response?

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Correct answer: A — HLA-B27 supports diagnosis but is not useful for monitoring disease activity

HLA-B27 is a genetic marker and does not change with treatment, so serial testing is not useful. CRP can support monitoring but may be normal despite active disease in some patients. MRI can help in selected cases, particularly when symptoms and clinical markers conflict.

Reference: NICE NG65; ASAS-EULAR axial spondyloarthritis recommendations