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Clinical Challenges in the Diagnosis and Management of Knee Osteoarthritis

  • Authors: John C. Richmond, MD
  • CME Released: 4/26/2019
  • Valid for credit through: 4/26/2020, 11:59 PM EST
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Target Audience and Goal Statement

This activity is intended for orthopedists and orthopedic surgeons, rheumatologists, and primary care physicians.

The goal of this activity is to improve physicians' knowledge of assessing patients and selecting a treatment for the management of knee OA, as well as selecting patients appropriate for intra-articular steroid treatment of knee OA.

Upon completion of this activity, participants will:

  • Have greater competence related to
    • Selecting patients appropriate for intra-articular steroid treatment of knee OA
    • Assessing patients for knee OA
    • Selecting a treatment for the management of knee OA


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Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.


  • John C. Richmond, MD

    Professor of Orthopedic Surgery
    New England Baptist Hospital
    Tufts University School of Medicine
    Boston, Massachusetts


    Disclosure: John C. Richmond, MD, has disclosed the following relevant financial relationships:
    Served as an advisor or consultant for: Flexion Therapeutics; Histogenics
    Served as a speaker or a member of a speakers bureau for: Flexion Therapeutics


  • Pakinam Aboulsaoud, PharmD

    Medical Education Director, Medscape, LLC


    Disclosure: Pakinam Aboulsaoud, PharmD, has disclosed no relevant financial relationships.

  • Megan Whitney, DMD

    Medical Writer


    Disclosure: Megan Whitney, DMD, has disclosed the following relevant financial relationships:
    Medical writing for Conformis, Inc.

CME Reviewer

  • Nafeez Zawahir, MD

    CME Clinical Director, Medscape, LLC


    Disclosure: Nafeez Zawahir, MD, has disclosed no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has disclosed the following relevant financial relationships:
Received grants for educational activities from: Medacta
Owns stock, stock options, or bonds from: Risalto Healthcare
Served as an advisor or consultant for: Medacta

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    For Physicians

  • Medscape, LLC designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Medscape, LLC staff have disclosed that they have no relevant financial relationships.

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This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 75% on the post-test.

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Clinical Challenges in the Diagnosis and Management of Knee Osteoarthritis

Authors: John C. Richmond, MDFaculty and Disclosures

CME Released: 4/26/2019

Valid for credit through: 4/26/2020, 11:59 PM EST


The following cases are modeled on the interactive grand rounds approach. The questions within the activity are designed to test your current knowledge. After each question, you will be able to see whether you answered correctly and read evidence-based information that supports the most appropriate answer choice. The questions are designed to challenge you; you will not be penalized for answering the questions incorrectly. At the end of the activity, there will be a short post-test assessment based on the material presented.

Case 1: Patient History

Michael is a 52-year-old accountant with an active lifestyle. Until recently, he played tennis 3 days per week. He reports pain in his left knee when climbing stairs and playing tennis. He recalls that he injured his knee 2 years ago and his primary care physician (PCP) "took an x-ray and said there were a few bone spurs." His PCP recommended physical therapy (PT) and naproxen sodium, taken as needed. Michael states that PT is helpful, but his pain has increased in the past 3 months and the naproxen is no longer effective.

Table 1. History and Physical Examination Findings

History Findings
Systemic No history of systemic disease
Surgical Appendectomy 1977
Current medications Naproxen sodium 220 mg as needed for pain; daily multivitamin
Physical Examination Findings
Vital signs BP = 122/72 mm Hg; HR = 80 bpm; RR = 16 breaths/min; oral temperature = 36.7°C
Height 183 cm
Weight 82.3 kg
General impression Well-nourished and hydrated; cognitively intact
Skin Normal
Head and neck Normal
Chest and lungs Normal
Abdomen Normal
Upper and lower extremities Normal at rest
BP = blood pressure; HR = heart rate; RR = respiratory rate.
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