Knee osteoarthritis — SCE Rheumatology MCQ

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EasyOsteoarthritis and Soft Tissue RheumatologyKnee osteoarthritisSCE Rheumatology

A 67-year-old woman has chronic bilateral knee pain worse on stairs and after prolonged walking. Morning stiffness lasts 10 minutes. Knee radiographs show medial joint-space narrowing and osteophytes. BMI is 33 kg/m² and she has no inflammatory synovitis. What is the most appropriate management?

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Correct answer: A — Exercise and weight-management support

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

Offer therapeutic exercise and weight management support is best because core osteoarthritis management includes therapeutic exercise, education and weight management where relevant. B is less suitable because methotrexate is not used for primary knee OA; C is less suitable because rituximab has no role in OA; D is less suitable because immobilisation worsens function and muscle strength; E is less suitable because long-term prednisolone is not OA treatment. Clinical pearl: analgesia supports exercise; it does not replace non-pharmacological treatment.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/musculoskeletal-conditions