Rheumatology Q 8

A 55-year-old woman is evaluated for an 18-month history of increasingly severe knee pain with the inability to arise when seated on the floor. She does not have pain at rest or nocturnal pain. Medications are celecoxib and omeprazole.

On physical examination, vital signs are normal. Bony hypertrophy of both knees is present. There is no warmth, erythema, or swelling of the joints.

Plain anteroposterior knee radiographs show medial joint space narrowing, peaking of the tibial spines, and osteophytes; there are no erosions or osteopenia.

Which of the following is the most appropriate management?

A Glucosamine supplements

B Knee replacement surgery

C Physical therapy

D Prednisone

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