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Knee osteoarthritis — SCE Rheumatology MCQ

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HardOsteoarthritis and Soft Tissue RheumatologyKnee osteoarthritisSCE Rheumatology

A 72-year-old with severe knee osteoarthritis has persistent pain, major functional limitation and progressive varus deformity despite appropriate exercise, weight-management support and analgesia. BMI is 41 kg/m² and an Oxford Knee Score is above the local administrative cut-off. What should the clinician do?

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Reveal the answer and explanation

Correct answer: A — Refer clinically for joint replacement without BMI or score exclusion

Explanation lettering: C = shown as A · D = shown as B · E = shown as C · A = shown as D · B = shown as E

C is correct. NICE bases referral on symptoms, quality-of-life impact and failure or unsuitability of non-surgical care. BMI and numerical scoring tools must not be used as automatic barriers. A and E impose an excluded BMI rule. B uses serial imaging rather than clinical need. D substitutes an administrative score for shared clinical assessment.

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