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
Filed under: USMLE Test Prep | Tagged: Archer Rheumatology, archer usmle step 3, Archer USMLE Step 3 X-rays |
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B
C
pt has OA,tm is acetaminophen,exercise,tai chi is gentle exercise so B
B