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Rheumatoid arthritis early disease — RACP Adult Medicine MCQ

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ModerateRheumatologyRheumatoid arthritis early diseaseRACP Adult Medicine

A 48-year-old woman has 4 months of symmetrical MCP and wrist pain with morning stiffness. Examination shows synovitis in both wrists and several MCP joints. RF and anti-CCP are positive; erosions are absent. What is the most important prognostic factor?

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Correct answer: D — Anti-CCP positivity with persistent inflammatory synovitis

Anti-CCP positivity and persistent synovitis predict erosive, persistent rheumatoid arthritis and support early treat-to-target DMARD therapy. Normal CK does not stage RA risk. Oedema, paracetamol use and urate are not key prognostic markers for RA progression.

Reference: Australian Rheumatology Association guidance; Therapeutic Guidelines (eTG); AMH