Question of the Week # 153

153) A 68 year old man presents to the clinic for progressive right hip pain. He has a history of hearing impairment. He reports pain in the right hip when walking more than 1 block and also, has difficulty putting shoes on his right foot. On examination, the range of motion is significantly limited in the right hip. An X-ray of the right hip reveals significant loss of cartilage, subchondral sclerosis and sub-chondral cysts. X-ray also reveals pagetoid changes in the right liac wing and right femoral neck. Serum alkaline phosphatase level is normal. The most appropriate initial step in managing this patient is:

A) Bisphosphanates

B) Acetaminophen, Quadriceps strtengthening and Tai-Chi

C) Bisphosphanates and Acetaminoiphen

D) Calcitonin

E) Oral prednisone

4 Responses

  1. C

  2. pt has OA,tm is acetaminophen,exercise,tai chi is gentle exercise so B

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