Rheumatoid Arthritis: The Daily PANCE Blueprint

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Rheumatoid Arthritis: The Daily PANCE Blueprint

A 48-year-old woman with symmetric MCP/PIP swelling, morning stiffness >1 hour, and +anti-CCP has hand X-rays showing marginal erosions. She is seropositive and reports firm, painless nodules over her elbows. Which extra-articular manifestation is most characteristic of her disease subtype?

A. Uveitis
B. Subcutaneous nodules
C. Oral ulcers
D. Erythema nodosum
E. CPP crystals

Answer and topic summary

The answer is Subcutaneous nodules

Seropositive erosive rheumatoid arthritis (RA) is strongly associated with rheumatoid nodules—granulomatous lesions at pressure points, such as the olecranon and extensor surfaces.

  • Uveitis – Seen in HLA-B27 spondyloarthropathies.
  • Oral ulcers – More consistent with SLE or Behçet.
  • Erythema nodosum – Seen in sarcoidosis, streptococcal infection, IBD.
  • CPP crystals – Indicates pseudogout, not RA.
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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Musculoskeletal ⇒ Rheumatologic Disorders (PEARLS) ⇒ Rheumatoid arthritis

Also covered in the Internal Medicine and Family Medicine PAEA EOR topic lists

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