MKSAP: 64-year-old man with knee osteoarthritis

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 64-year-old man is evaluated for a 2-year history of knee osteoarthritis. He has bilateral knee pain that worsens with walking. He has tried topical therapies, physical therapy, and acetaminophen, none of which has provided relief. The patient also has peripheral vascular disease, hyperlipidemia, and hypertension. Medications are hydrochlorothiazide, pravastatin, and a daily aspirin. On physical examination, temperature is 37.0 °C (98.6 °F), blood pressure is 116/76 mm Hg, pulse rate is 60/min, and respiration rate is 12/min. BMI is 26. Musculoskeletal examination reveals small knee effusions bilaterally, with crepitus and tenderness along the medial joint line. Laboratory studies, including complete blood count, erythrocyte sedimentation rate, plasma glucose, and serum creatinine, are normal. Radiographs of the knees, including weight-bearing studies, reveal bilateral medial joint-space narrowing, subchondral sclerosis, and small osteophytes. Which of the following is the most appropriate treatment for this patient? A: Celecoxib B: Colchicine C: Indomethacin D: Prednisone E: Tramadol Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Meds Rheumatology Source Type: blogs