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Hand osteoarthritis — SCE Rheumatology MCQ

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HardOsteoarthritis and Soft Tissue RheumatologyHand osteoarthritisSCE Rheumatology

A 66-year-old man has thumb-base and DIP osteoarthritis with activity-related pain. What is the best initial management package?

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Correct answer: B — Use hand exercise, activity support and topical NSAID treatment

The best answer is “Use hand exercise, activity support and topical NSAID treatment”. Core osteoarthritis care combines therapeutic exercise, information and support, with topical NSAID treatment considered according to joint site and individual risk. Methotrexate and systemic glucocorticoids are not routine hand-osteoarthritis treatments, aspiration is reserved for diagnostic uncertainty such as suspected infection, and surgery follows appropriate non-surgical care.

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