Chapter 46 – Osteoarthritis (QE) Sample Questions
1. DS, a 55 year old patient reported to his family doctor joint pain in her hip with debilitating stiffness in the morning which lasts for less than 30 minutes. The doctor examined DS’s knee and found normal alignment pattern. When asked, Patient denied limping when walking for more than 5 minutes. Sit to Stand test was done and patient was able to complete greater than three repetitions in 30 seconds. Ordered an x-ray and US and ordered blood works for RH, ESR and CRP to rule other inflammatory diseases. Doctor then evaluated DS symptoms consistent to osteoarthritis. Other medical condition includes hypertension for which he takes bisoprolol 10 mg daily po and hydrochlorothiazide 12.5 mg daily po and esomeprazole 20 mg daily. BP: 135/90, SrCr: 110 µmol/L, K: 3.4 mmol/L. If a doctor opts a topical over an oral agent, what would you recommend the doctor to give DS?
- A. Diclofenac
- B. Capsaicin
- C. Lidocaine
- D. Gabapentin
Ans:
B
Tips: Topical NSAIDs are better tolerated than oral NSAIDs and have similar effects on pain and function. Topical capsaicin is also effective for the treatment of chronic pain.
According to The college of Family Physicians of Canada osteoarthritis tool, Hip alignment is usually checked in patients with suspected hip OA. Sit to Stand test is one of the measures of function and strength to classify early, moderate and advance stage of OA.
Early stage: able to complete >15 repetitions for 30 seconds
Moderate stage: able to complete 2-3 repetitions for 30 seconds
Advanced: unable to complete one repetition where neurological and cardiac functions are normal
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