A 60-year-old female presents with pain in her knees. The
pain increases after use and is relieved by rest. There are no systemic
On examination she is obese. On examination of the hands
there are Heberdenís nodes and Bouchardís nodes. The knees show bony
swelling; there is localised joint and periarticular tenderness. The range of
movement is decreased and there is crepitus on movement.
Investigations show normal haematology and biochemistry
and inflammatory markers are not raised.
In this patient,
the pharmacological intervention of first choice should be treatment with:
Non Steroidal Anti Inflammatory Drugs (NSAIDs)