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Osteoarthritis — ABIM Board MCQ

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ModerateRheumatology/Allergy/ImmunologyOsteoarthritisABIM Board

A 67-year-old with obesity has painful radiographic knee osteoarthritis, hypertension and CKD stage 3. She wants nonoperative care and has no skin contraindication. Which initial plan best balances benefit and systemic risk?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Combine exercise and weight loss with a trial of topical NSAID therapy

The best answer is “Combine exercise and weight loss with a trial of topical NSAID therapy”. Exercise and weight reduction improve pain and function, and a topical NSAID offers lower systemic exposure than an oral NSAID—valuable in CKD and hypertension. Chronic systemic glucocorticoids, bed rest and antibiotics do not treat osteoarthritis and add substantial harm.

Reference: 2019 ACR/Arthritis Foundation Osteoarthritis Guideline: https://pmc.ncbi.nlm.nih.gov/articles/PMC10518852/