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NICE Paracetamol Removed OA — SCE Rheumatology MCQ

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HardOsteoarthritisNICE Paracetamol Removed OASCE Rheumatology

A patient with knee osteoarthritis asks whether regular paracetamol should be used routinely when topical NSAIDs are suitable. What does NICE advise?

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Correct answer: A — Do not routinely offer paracetamol unless other pharmacological options are unsuitable

The best answer is “Do not routinely offer paracetamol unless other pharmacological options are unsuitable”. NICE advises against routinely offering paracetamol for osteoarthritis unless it is used infrequently for short-term pain relief and other pharmacological treatments are contraindicated, not tolerated or ineffective. The remaining choices—“Offer regular paracetamol before non-pharmacological treatment, after specialist assessment”, “Combine paracetamol with a strong opioid as initial therapy, with clinical reassessment”, “Use paracetamol principally when radiographs show severe disease, within a rheumatology pathway”, “Use paracetamol to prevent structural progression, after safety review”—are credible in related rheumatology presentations, but each addresses a different diagnosis, investigation, treatment sequence or complication and does not fit the decisive findings in this stem.

Reference: NICE NG226 osteoarthritis: https://www.nice.org.uk/guidance/ng226/chapter/Recommendations