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Rheumatoid arthritis — RCPSC IM MCQ

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EasyRheumatologyRheumatoid arthritisRCPSC IM

A 55-year-old woman has symmetric swelling of the MCP and PIP joints for 4 months, morning stiffness for 2 hours, positive anti-CCP antibody, and erosions on hand radiographs. She has no liver disease and normal creatinine. She wants to avoid long-term glucocorticoids. What is the most appropriate management?

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Correct answer: A — Start methotrexate with folic acid and monitoring

Erosive anti-CCP positive rheumatoid arthritis warrants early disease-modifying therapy. Methotrexate is the usual anchor DMARD when not contraindicated; NSAIDs alone do not prevent progression.

Reference: Canadian Rheumatology Association RA guidance