Osteoarthritis: The Daily PANCE Blueprint
A 62-year-old woman presents with chronic right knee pain that worsens with activity and improves with rest. She has morning stiffness lasting about 15 minutes, bony enlargement of the distal finger joints, and crepitus on knee movement. There is no warmth, and inflammatory markers are normal. Which of the following is the most likely diagnosis?
A. Osteoarthritis
B. Rheumatoid arthritis
C. Gout
D. Septic arthritis
E. Systemic lupus erythematosus
Answer and topic summary
The answer is A. Osteoarthritis.
Activity-related joint pain that improves with rest, brief morning stiffness (under 30 minutes), bony enlargement of the distal interphalangeal joints (Heberden nodes), and crepitus without warmth or elevated inflammatory markers is osteoarthritis. Rheumatoid arthritis instead causes prolonged morning stiffness (over an hour), symmetric small-joint synovitis sparing the distal interphalangeal joints, and elevated inflammatory markers. Gout is acute and monoarticular; septic arthritis is hot and febrile; and lupus is a multisystem inflammatory disease. First-line management is exercise and weight loss plus topical or oral NSAIDs.
View blueprint lesson
Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Musculoskeletal ⇒ ⇒
