SCE Rheumatology: question practice and revision.

Choose a topic for focused revision and check your plan against the official specification.

• Rheumatoid arthritis — DAS28, treat-to-target, csDMARDs, bDMARDs, tsDMARDs (JAKi safety)
• Spondyloarthritis — axial SpA, psoriatic arthritis, IBD-associated, juvenile transition
• Connective tissue disease — SLE, Sjögren, scleroderma (SSc), MCTD, autoantibody panels
• Vasculitis — Chapel Hill 2012 / 2022 ACR/EULAR criteria, ANCA, large-vessel, IgA, single-organ
• Myositis and idiopathic inflammatory myopathies — anti-MDA5, anti-Jo-1, anti-Mi-2, autoantibody-disease links
• Crystal arthritis — gout, CPPD, calcium oxalate, calcium hydroxyapatite, ULT thresholds
• Osteoarthritis and back pain — non-pharmacological, surgical referral, red flags
• Metabolic bone disease — osteoporosis (DXA, FRAX, romosozumab/teriparatide), Paget's, osteomalacia
• Paediatric and adolescent rheumatology — JIA categories, uveitis screening, transition to adult
• Soft tissue and regional MSK — tendinopathy, fibromyalgia, hypermobility (hEDS)
• Infection in rheumatology — septic arthritis, biologic-related infection, prosthetic joint infection
• Statistics, ethics, professional behaviours, EBM in rheumatology
• Rare and overlapping — relapsing polychondritis, IgG4-RD, sarcoid arthropathy, VEXAS syndrome

Drawn from the JRCPTB curriculum, BSR/EULAR/ACR guidelines and item density in iatroX.

• Rheumatoid arthritis — EULAR 2022 treat-to-target, csDMARD failure to bDMARD sequencing, JAKi safety signals (ORAL Surveillance — MACE, malignancy, VTE), risankizumab and IL-23 inhibitors for psoriatic arthritis
• Axial spondyloarthritis — ASAS classification, MRI sacroiliitis criteria (BME in subchondral bone, EULAR-OMERACT), TNF inhibitors vs IL-17 (secukinumab, ixekizumab, bimekizumab), JAKi (upadacitinib) in r-axSpA
• SLE — 2019 EULAR/ACR criteria, lupus nephritis induction (MMF, cyclophosphamide, voclosporin, belimumab combination), hydroxychloroquine essential role, anifrolumab (anti-IFN-α) in non-renal SLE
• ANCA-associated vasculitis — KDIGO/EULAR 2022 — rituximab vs cyclophosphamide induction, avacopan (oral C5a receptor antagonist) replacing or sparing steroids, maintenance rituximab
• Giant cell arteritis — tocilizumab steroid-sparing per GiACTA, imaging strategy (US-temporal, MRI, PET-CT for large vessel), recognising large-vessel GCA vs Takayasu
• Systemic sclerosis — autoantibody-disease links (anti-Scl-70/topo I → ILD/diffuse, anti-centromere → limited/PAH, anti-RNA pol III → renal crisis), nintedanib for SSc-ILD per SENSCIS, autologous HSCT
• Gout — ULT initiation thresholds (>1 attack, tophi, CKD, urolithiasis), allopurinol vs febuxostat (CARES safety considerations), pegloticase in refractory gout, target urate <300/360
• Newer rare conditions — VEXAS syndrome (UBA1 mosaicism, autoinflammation + haematological), IgG4-RD (storiform fibrosis, obliterative phlebitis), relapsing polychondritis

Observations from UK rheumatology trainees and recent SCE candidates. Verify against current BSR, EULAR and NICE guidance.

Candidate-reported observations — not official guidance.

1. JAK inhibitor safety — post-ORAL Surveillance (2022), MHRA and EMA restrictions apply (≥65, smokers, CVD risk factors, malignancy history). The class warning is examined directly.
2. Autoantibody-disease pattern recognition — anti-Mi-2 (classical DM, good response), anti-MDA5 (rapidly progressive ILD, amyopathic DM), anti-Jo-1 and other ARS (antisynthetase syndrome), anti-SRP (necrotising myopathy). Frequently muddled.
3. Lupus nephritis treatment — voclosporin + MMF + steroid triple therapy per AURORA, belimumab + standard care per BLISS-LN. Mixing trial settings is a common error.
4. Vasculitis classification — Chapel Hill 2012 vs 2022 ACR/EULAR criteria for AAV, IgA vasculitis adults vs children, single-organ vasculitis (e.g. primary CNS, isolated cutaneous).
5. Giant cell arteritis imaging — temporal artery US halo sign, MRI vessel wall, PET-CT for large-vessel involvement. Knowing first-line imaging modality and biopsy timing matters.
6. Crystal arthritis — distinguishing monosodium urate (gout, negative birefringent needle) from calcium pyrophosphate (CPPD, positive birefringent rhomboid) under polarised microscopy. Histology images appear directly.
7. VEXAS syndrome — newly described (2020). UBA1 mosaicism causes autoinflammation + macrocytosis + vacuoles in myeloid precursors. Recently added to SCE content.
8. Statistics in rheumatology trials — ORAL Surveillance (composite cardiovascular outcome), MAIA in lupus nephritis (renal response), SENSCIS in SSc-ILD (FVC decline). Knowing primary endpoints and NNT.

A pragmatic phased approach used by recent ST5–ST6 rheumatology passers.

1. Weeks 1–6

   Foundation pass across all 13 blueprint topics. 30 questions/day with the iatroX adaptive engine. Build autoantibody-disease pattern recognition early. Read EULAR recommendations for RA, axSpA, PsA, SLE, vasculitis.

2. Weeks 7–11

   Targeted weak-area drilling. Map every BSR biologics guideline, EULAR 2022/24 updates (treat-to-target, JAKi safety, AAV with avacopan), 2022 ACR/EULAR ANCA criteria. Practise capillaroscopy and joint US pattern recognition.

3. Weeks 12–14

   Two timed 200-SBA mock exams under exam conditions weekly. Practise autoantibody panel interpretation and synovial fluid microscopy under time pressure. Review trial primary endpoints.

4. Weeks 15–16

   Bookmark review only. Targeted reading on VEXAS syndrome, IgG4-RD diagnostic criteria, anifrolumab and bimekizumab. Confirm Pearson VUE booking. Sleep, hydrate, do not learn new material.

Dedicated SCE Rheumatology question practice with answer explanations, guided Tutor review and study planning.

• Focused question practice — Choose the relevant bank and use your answers to identify what to study next.
• Guided reasoning — Explore a difficult answer with Tutor, then apply the distinction independently.
• Review and timed practice — Return to important mistakes and choose a timed practice set where available.

Choose the relevant bank and use the official exam guidance to plan your preparation.

Use the dedicated SCE Rheumatology bank for question practice and answer explanations. Choose a practice set to see its available count and timing, then use the official specification to plan your wider preparation.

Next SCE Rheumatology sitting: 16 June 2027. Applications: 24 February 2027–24 March 2027. Applications open and close at 08:00 UK local time. Confirm booking and delivery arrangements with the Federation.

Two papers of 100 best-of-five SBAs each, three hours per paper, sat on the same day with a one-hour break between. Total 200 questions. The June 2026 sitting marks the Federation's transition to in-centre delivery at Pearson VUE locations. Paper 2 is widely reported to carry more image-led items (US, X-ray, MRI, capillaroscopy, synovial fluid microscopy).

Most UK trainees sit during ST5 or ST6 (penultimate year of higher specialty training). There are no formal restrictions on when in training you sit, but CCT requires a pass before completion. International candidates can sit at any time once registered with the Federation.

UK fee is £700; international fee is £875. Fees are non-refundable after the application closing date. From June 2026 all sittings are delivered in-centre at Pearson VUE locations.

Autoantibody-disease pattern recognition is one of the highest-yield areas. iatroX includes detailed panels — ANA pattern (homogeneous, speckled, nucleolar, centromere) interpretation, anti-ENA subtypes, anti-CCP and RF, myositis-specific autoantibodies (anti-MDA5, anti-Jo-1, anti-Mi-2, anti-SRP), and scleroderma-specific antibodies.

Full SCE Rheumatology bank access is included in all-access. Up to 10 new sample questions per day are shared across exams, with no account required. A verified free account includes one guided Tutor session; continued Tutor use is included in all-access.