26th February 2025

A 45-year-old woman is reviewed in rheumatology clinic.

A 45-year-old woman is reviewed in rheumatology clinic. She has been referred by her general practitioner after presenting with difficulty climbing the stairs. She had started to notice some slight leg weakness around 8 months ago; however, now it has progressed to the point where she has to use her arms to lift her legs when going up stairs.

She has no past medical history and takes no regular medications.

On examination, power is 4/5 at the hip flexors bilaterally and 5/5 at all other muscle groups examined. There is no skin rash or synovitis.

She has had the following blood tests in primary care:

 Given the most likely diagnosis, which antibody is most likely to be positive?

Select the SINGLE most appropriate option from the list below. Select ONE option only.