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Osteoarthritis — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareOsteoarthritisUSMLE Step 3

A 64-year-old woman has chronic bilateral knee pain worse with stairs and prolonged walking. Morning stiffness lasts 10 minutes. Examination shows crepitus and bony enlargement without warmth or effusion. She has hypertension and stage 3 chronic kidney disease. Which of the following is the most appropriate next step in management?

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

Reveal the answer and explanation

Correct answer: E — Recommend exercise therapy and topical diclofenac

Knee osteoarthritis is managed with exercise, weight management, and topical NSAIDs when systemic NSAIDs pose renal or cardiovascular risk.

Reference: American College of Rheumatology osteoarthritis guideline: https://rheumatology.org/