Question:
A 14-year-old child is a naive rheumatoid arthritis patient as shown in the image. What should be the correct treatment of the given condition?
A 14-year-old child is a naive rheumatoid arthritis patient as shown in the image. What should be the correct treatment of the given condition?
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Treatment-naive RA needs an early DMARD with a short steroid bridge, not NSAIDs alone or delayed therapy.
Updated On: Jun 23, 2026
- DMARD with short course of steroids
- Only NSAIDs
- DMARD after initial 3 months of NSAIDs
- Monotherapy with TNF drugs
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The Correct Option is A
Solution and Explanation
Step 1: The image shows the deforming polyarthritis of rheumatoid arthritis (RA), a chronic autoimmune inflammatory disease that predominantly attacks the synovial joints in a symmetrical pattern.
Step 2: The aim of treatment is to control symptoms and slow disease progression. In a treatment-naive patient, disease-modifying anti-rheumatic drugs (DMARDs) should be started early to limit joint damage.
Step 3: A short course of corticosteroids is added alongside the DMARD to bridge symptom control while the slower-acting DMARD takes effect. Hence DMARD with a short course of steroids is the correct initial regimen.
Step 4: NSAIDs alone (option b) or delaying DMARDs for 3 months (option c) allows ongoing joint destruction and is outdated. TNF antagonists (option d) are reserved for inadequate response to DMARDs and are not first-line monotherapy, so they are incorrect.
Step 2: The aim of treatment is to control symptoms and slow disease progression. In a treatment-naive patient, disease-modifying anti-rheumatic drugs (DMARDs) should be started early to limit joint damage.
Step 3: A short course of corticosteroids is added alongside the DMARD to bridge symptom control while the slower-acting DMARD takes effect. Hence DMARD with a short course of steroids is the correct initial regimen.
Step 4: NSAIDs alone (option b) or delaying DMARDs for 3 months (option c) allows ongoing joint destruction and is outdated. TNF antagonists (option d) are reserved for inadequate response to DMARDs and are not first-line monotherapy, so they are incorrect.
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