Update your Knowledge with MKSAP 19 Q&A

For nearly 60 years, ACP’s Medical Knowledge Self-Assessment Program^SM (MKSAP ^SM) has been the most trusted resource in self-assessment and continuous learning for internal medicine physicians and residents. The tradition continues with ACP MKSAP^SM. The all-digital, subscription-based program provides continually updated clinical information, a robust question bank, and the opportunity to unlock additional questions and earn badges through ACP MKSAP CORE^TM. ACP Members enjoy discounted pricing on their one-year or three-year subscriptions.

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ACP MKSAP Rheumatology

A 42-year-old man is evaluated for a 2-month history of right groin pain with activity and at night. He has not experienced recent injury or increased his physical activity. Medical history is notable for systemic lupus erythematosus diagnosed 6 months ago with manifestations of facial rash, pericarditis, and nephritis. He was initially treated with high-dose prednisone, mycophenolate mofetil, and hydroxychloroquine. This regimen controlled his disease, and he is tapering the prednisone dose. Current medications are mycophenolate mofetil; hydroxychloroquine; and prednisone, 15 mg/d.

On physical examination, vital signs are normal. Mild cushingoid facies is observed. Internal rotation and flexion of the right hip elicit pain. No periarticular tenderness or joint swelling is noted. The remainder of the examination is normal.

Radiographs of the pelvis and right hip are normal.

Which of the following is the most appropriate diagnostic test to perform next?

A: Arthroscopy
B: Bone scan
C: MRI
D: Ultrasonography

Answer and Critique

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