A 68-year-old female presents to the clinic with a 6-month history of right knee pain that worsens with activity and improves with rest. She reports stiffness in the morning that lasts about 30 minutes. The patient has a history of obesity and hypertension. Physical Exam Findings: General: Overweight female, walks with a slight limp Inspection: Mild swelling around the right knee, no deformities Palpation: Tenderness over the joint line, crepitus noted during movement Range of motion: Slightly decreased, especially with flexion MCQs: What is the most likely diagnosis for this patient? A) Rheumatoid arthritis B) Osteoarthritis C) Gout D) Meniscus tear Which non-pharmacological management strategy should be recommended? A) Complete bed rest B) Weight loss and physical therapy C) Joint immobilization D) Heat therapy only When would it be appropriate to refer this patient to orthopedics? A) If conservative management fails after 6 weeks B) If the patient is over 70 years old C) If there are no indications of inflammation D) If the patient prefers surgery Answers with Explanations: Answer: B) Osteoarthritis Explanation: The patient's age, symptoms, and exam findings are consistent with osteoarthritis of the knee, a common condition in elderly patients. Answer: B) Weight loss and physical therapy Explanation: Non-pharmacological management includes weight loss to reduce stress on the knee and physical therapy to improve strength and function. Answer: A) If conservative management fails after 6 weeks Explanation: Referral to orthopedics is indicated if there is no improvement after a reasonable period of conservative treatment. Overview of the Topic: Osteoarthritis Management in Elderly Patients Osteoarthritis is a prevalent condition among the elderly, and management should focus on lifestyle modifications, non-pharmacological treatments, and pharmacological options when necessary. Key Learning Points: Early recognition and management can improve function and quality of life. Referral to orthopedics may be necessary for surgical options if conservative measures are ineffective.
