<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 39-year-old woman comes to the physician because of progressive pain and swelling of her wrists and hands for the past 2 months. Her hands are stiff in the morning; the stiffness decreases as she starts her chores. She also reports early-morning neck pain at rest for the past 3 weeks. She has no history of serious illness and takes no medications. Her sister has systemic lupus erythematosus. Vital signs are within normal limits. Examination shows bilateral swelling and tenderness of the wrists, second, third, and fourth metacarpophalangeal joints; range of motion is limited by pain. There is no vertebral tenderness. Cardiopulmonary examination shows no abnormalities. Neurologic examination shows no focal findings. Laboratory studies show:Hemoglobin 12.8 gdLLeukocyte count 9,800mm3Erythrocyte sedimentation rate 44 mmhSerumGlucose 77 mgdLCreatinine 1.1 mgdLTotal bilirubin 0.7 mgdLAlkaline phosphatase 33 ULAST 14 ULALT 13 ULRheumatoid factor positiveWhich of the following is the most appropriate next step in management?? A: Adalimumab, B: X-ray of the cervical spine, C: Measurement of anti-Smith antibodies, D: CT scan of the chest, E: Tuberculin skin test,  <response>: This is a clinical vignette describing a 39-year-old woman with progressive pain and swelling of the wrists and hands over 2 months, morning stiffness in her hands, and early morning neck pain over 3 weeks. Her sister has systemic lupus erythematosus. Exam shows swelling and tenderness of wrists and MCP joints with limited range of motion due to pain. Labs show elevated ESR and positive rheumatoid factor. This presentation is most consistent with rheumatoid arthritis. The next step would be to confirm the diagnosis and assess disease severity with imaging. Choice B, X-ray of the cervical spine, is the best next step to evaluate for cervical spine involvement and damage that may guide treatment. Choices A, C, D, and E are not useful next steps. B: X-ray of the cervical spine 