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Knee osteoarthritis topical NSAID use — USMLE Step 3 MCQ

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HardAmbulatory Medicine / Primary CareKnee osteoarthritis topical NSAID useUSMLE Step 3

A 67-year-old man has chronic bilateral knee pain from osteoarthritis. He has hypertension, chronic kidney disease stage 3, and prior peptic ulcer bleeding. He asks for pain control that avoids systemic adverse effects. Which of the following is the most likely explanation for this patient's findings?

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Correct answer: C — Local anti-inflammatory effect with lower systemic NSAID exposure

Topical NSAIDs can reduce osteoarthritis pain with lower systemic exposure than oral NSAIDs, making them useful when oral NSAID toxicity risk is high.

Reference: ACR/Arthritis Foundation osteoarthritis guideline