best management for Osteoarthritis with paget??? - USMLE Forums
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Old 03-05-2013
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Default best management for Osteoarthritis with paget???

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
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  #2  
Old 03-05-2013
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bisphosphonate for the decreasing the paget activity and preventing further worsening of its complication(osteoarthritis) PLUS acetaminophen for the pain of osteoarthritis....
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Old 03-05-2013
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Answer is B...no need for biphosphonates without elevated ALP...tai chi is a low impact exercise beneficial in osteoarthritis and so also is quadriceps strengthening.
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