1. Pain (visual analogue scale)
2. X-Ray of hands and wrists
3. DAS 28 score
4. ESR
Select the correct answer using the code given below :
Monitoring Disease Activity in Rheumatoid Arthritis
Rheumatoid arthritis (RA) management requires regular assessment of disease activity (the current inflammatory burden) as distinct from assessment of structural damage (the cumulative, largely irreversible joint destruction caused by past inflammation). Composite activity indices, patient-reported symptom scores, and acute-phase reactants are used for the former; imaging is used for the latter.
Analysis of Each Option
- 1. Pain (Visual Analogue Scale): Correct. Patient-reported pain on a VAS is a core component of RA activity assessment and feeds directly into composite indices; it reflects the current symptomatic/inflammatory state.
- 2. X-ray of hands and wrists: Incorrect for monitoring activity. Radiographs detect erosions and joint space narrowing, which are markers of cumulative structural damage, not real-time disease activity. Radiographic changes are often irreversible and change slowly (assessed yearly), so X-rays cannot be used to track short-term fluctuations in activity — they answer "how much joint damage has accumulated," not "how active is the disease right now."
- 3. DAS 28 score: Correct. The Disease Activity Score in 28 joints is the standard validated composite tool for RA, combining tender joint count, swollen joint count, patient global assessment, and an inflammatory marker (ESR or CRP) into a single activity score used to guide treat-to-target therapy.
- 4. ESR: Correct. Erythrocyte sedimentation rate is an acute-phase reactant that rises with active synovial inflammation and is one of the standard laboratory markers (along with CRP) used both independently and as part of the DAS 28 to track disease activity over time.
Conclusion
Disease activity in RA is monitored using subjective and inflammatory parameters — pain scores, composite indices like DAS 28, and inflammatory markers like ESR — which change in step with current disease activity. X-rays instead capture the structural damage that has already occurred and are used for damage/progression assessment, not activity monitoring. Hence, the correct combination is 1, 3 and 4.
Important Questions from Arthritis
- Which of the following statements regarding Ankylosing spondylitis (AS) are true?
1. AS occurs in about 10 % of Inflammatory Bowel Disease(IBD) patients
2. The AS activity is related to Bowel activity in IBD patients
3. The AS activity does remit with glucocorticoids or colectomy in IBD patients
Select the correct answer using the code given below: - Which of the following statements about “Early onset Osteoarthritis” are true?
1. Onset is usually before the age of 55 years
2. There is clear history of previous trauma
3. In most cases, single joint is affected
Select the correct answer using the code given below: - A 31-year young man presents with fever, weight loss, pain with swelling of knee joint and low backache with stiffness. Three weeks earlier, he was treated for symptoms of urinary tract infection by local practitioner. The joint aspirate is leucocyte rich and contains multinucleated macrophages. His urine culture is sterile. What is the most probable diagnosis?
- Consider the following statements regarding Gout in old age.
1. Most of older patients have gout secondary to diuretic use and chronic kidney disease
2. Joints of the upper limbs are more frequently affected
3. Presentation is typical with acute attack of gout
Which of the statements given above are correct? - A 28-year old woman complains of arthritis involving bilateral metacarpophalangeal, proximal interphalangeal and wrist joints of one year duration. The most likely disease entity is:
