oa ? - myx

[ArchivalUser]

A 65 yo white female complains of pain both knee joints. XR - osteophytes. PE - Joints not inflamed, non-tender
Most appropriate next step in management of this patient?
1. Weight reduction alone
2. Weight reduction + exercise
3. NSAIDs
4. Ask for stressors
5. TSH

[ArchivalUser]

Weight reduction + exercise

[ArchivalUser]

3 - NSAIDs
It asks for NEXT STEP. First see for her pain. Weight red and exercise is best in the long run

[ArchivalUser]

3-NSAIDs
Pt is in pain rt now so i guess first step should be analgesics.But for long term survival wt reduction & exercise will help.

[ArchivalUser]

myx what is the ans for this

[ArchivalUser]

agree NSAIDS the weight reduction and excercise

[ArchivalUser]

One thing is sure guys, when there is word P A I N, there is zero tolerance for this complain in US med system, because it is subjective feeling and you can not challenge the pt, always the first step should be to take care of the pain, until unless question uses some special word to trick you, which I dont see in this case, so agree with most of you NSAIDs.

[ArchivalUser]

This is the weirdest q so far I have come across. somebody asked me this q a few days ago.

I picked NSAID too. A and B are not appropriate as it does not mention if the pt is overweight ,obese or a thin lean female.

The answer , however is E.
The source quotes ' In many patients presenting with apparent OA, it is reasonable to measure TSH. Unexpected hypothyroidism is occasionally associated with joint pain without significant inflammation'

Let's take it ......Always put Thyroid in DD for every problem.

[ArchivalUser]

I am 100% sure this is not board Q
May be just teaching purpose Question