Rheumatoid Arthritis Diagnosed 6 in Medicine / Internal Medicine — 35yo Man | Rheumatology | SMLE Q#17429
SMLE Question #17429
Medicine / Internal Medicine
Rheumatology
Objective: OBJ-RA-ESCALATE-001
Last updated: February 2026
A 35-year-old man with rheumatoid arthritis diagnosed 6 months ago has worsening pain and swelling in both hands and feet with morning stiffness for 2 hours despite methotrexate 20 mg weekly and daily ibuprofen. Examination shows synovitis and tenderness of both wrists and several MCP joints. Hand X-rays show erosions at multiple joints. What is the most appropriate additional treatment?
Continue in practice mode
Sign in and start a focused practice session to view options, submit your answer, and read the full explanation.