Treatment Options, Risk Factors, and Osteoporosis Concerns in Elderly Patients

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Assignment Question

Musculoskeletal Function: G.J. is a 71-year-old overweight woman who presents to the Family Practice Clinic for the first time complaining of a long history of bilateral knee discomfort that becomes worse when it rains and usually feels better when the weather is warm and dry. “My arthritis hasn’t improved a bit this summer though,” she states. Discomfort in the left knee is greater than in the right knee. She has also suffered from low back pain for many years, but recently it has become worse. She is having difficulty using the stairs in her home. The patient had recently visited a rheumatologist who tried a variety of NSAIDs to help her with pain control. The medications gave her mild relief but also caused significant and intolerable stomach discomfort. Her pain was alleviated with oxycodone. However, when she showed increasing tolerance and began insisting on higher doses of the medication, the physician told her that she may need surgery and that he could not prescribe more oxycodone for her. She is now seeking medical care at the Family Practice Clinic. Her knees started to get significantly more painful after she gained 20 pounds during the past nine months. Her joints are most stiff when she has been sitting or lying for some time and they tend to “loosen up” with activity. The patient has always been worried about osteoporosis because several family members have been diagnosed with the disease. However, nonclinical manifestations of osteoporosis have developed. Case Study Questions Define osteoarthritis and explain the differences with osteoarthrosis. List and analyze the risk factors that are presented on the case that contribute to the diagnosis of osteoarthritis. Specify the main differences between osteoarthritis and rheumatoid arthritis, make sure to include clinical manifestations, major characteristics, joints usually affected and diagnostic methods. Describe the different treatment alternatives available, including non-pharmacological and pharmacological that you consider are appropriate for this patient and why. How would you handle the patient concern about osteoporosis? Describe your interventions and education you would provide to her regarding osteoporosis. Neurological Function: H.M is a 67-year-old female, who recently retired from being a school teacher for the last 40 years. Her husband died 2 years ago due to complications of a CVA. Past medical history: hypertension controlled with Olmesartan 20 mg by mouth once a day. Family history no contributory. Last annual visits with PCP with normal results. She lives by herself but her children live close to her and usually visit her two or three times a week. Her daughter start noticing that her mother is having problems focusing when talking to her, she is not keeping things at home as she used to, often is repeating and asking the same question several times and yesterday she has issues remembering her way back home from the grocery store. Case Study Questions Name the most common risks factors for Alzheimer’s disease Name and describe the similarities and the differences between Alzheimer’s disease, Vascular Dementia, Dementia with Lewy bodies, Frontotemporal dementia. Define and describe explicit and implicit memory. Describe the diagnosis criteria developed for the Alzheimer’s disease by the National Institute of Aging and the Alzheimer’s Association What would be the best therapeutic approach on C.J.



Musculoskeletal disorders are prevalent in the aging population and can significantly affect an individual’s quality of life. In this essay, we will delve deeper into the case of G.J., a 71-year-old woman who presents with knee and back pain. We will explore the definition of osteoarthritis, differentiate it from osteoarthrosis, analyze the risk factors contributing to G.J.’s diagnosis, compare osteoarthritis with rheumatoid arthritis, discuss available treatment alternatives – both non-pharmacological and pharmacological – and address G.J.’s concerns regarding osteoporosis.

Osteoarthritis vs. Osteoarthrosis

To begin, it is essential to clarify the distinction between osteoarthritis and osteoarthrosis. While these terms are often used interchangeably, osteoarthritis is the more accurate and widely accepted term. It is a degenerative joint disease characterized by the gradual breakdown of joint cartilage and the underlying bone. This degeneration leads to pain, stiffness, and reduced joint mobility. Osteoarthrosis, although still used in some contexts, is considered an outdated and less precise term for the same condition.

Risk Factors for Osteoarthritis

G.J.’s case presents several risk factors that contributed to her osteoarthritis diagnosis:

Age: Osteoarthritis is more common in older adults due to the cumulative wear and tear on joints over time.

Weight: Being overweight or obese increases the stress on weight-bearing joints, such as the knees, accelerating joint deterioration.

Weather Sensitivity: G.J.’s complaint of worsened discomfort during rainy weather is consistent with the weather sensitivity often experienced by osteoarthritis patients.

Family History: G.J.’s concerns about osteoporosis suggest a family history of musculoskeletal conditions, which can be a risk factor for osteoarthritis.

Osteoarthritis vs. Rheumatoid Arthritis

It is important to differentiate between osteoarthritis and rheumatoid arthritis, as they are distinct conditions:

Clinical Manifestations: Osteoarthritis primarily manifests as joint pain, stiffness, and reduced range of motion. In contrast, rheumatoid arthritis is an autoimmune disorder characterized by inflammation of the synovium lining the joints, leading to joint pain, swelling, and systemic symptoms.

Major Characteristics: Osteoarthritis primarily involves cartilage deterioration and gradual joint degeneration. Rheumatoid arthritis, on the other hand, is characterized by an autoimmune attack on the synovium, leading to joint inflammation.

Joints Usually Affected: While osteoarthritis commonly affects weight-bearing joints such as knees, hips, and spine, rheumatoid arthritis can affect any joint, including the hands and wrists.

Diagnostic Methods: Rheumatoid arthritis is diagnosed through blood tests that detect specific autoimmune markers. Osteoarthritis diagnosis primarily relies on clinical evaluation, medical history, and imaging studies, such as X-rays or MRI scans.

Treatment Options for G.J.

Managing osteoarthritis in patients like G.J. requires a comprehensive approach that may involve both non-pharmacological and pharmacological options:

Non-pharmacological Approaches: These include lifestyle modifications such as weight loss, physical therapy, and the use of assistive devices. Weight loss, in particular, can significantly reduce the stress on weight-bearing joints like the knees.

Pharmacological Options: Medications like nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen can provide pain relief. However, G.J.’s history of intolerance to NSAIDs, which caused significant stomach discomfort, warrants careful consideration. Opioids, like oxycodone, should be used cautiously and only when other options are insufficient, due to their potential for tolerance and dependency.

Addressing Osteoporosis Concerns

G.J.’s concerns about osteoporosis, a condition characterized by weakened bones, are valid given her family history. To address these concerns effectively, healthcare providers should consider the following interventions and education:

Bone Density Assessment: Conduct a bone density test, such as a Dual-Energy X-ray Absorptiometry (DEXA) scan, to assess G.J.’s bone health accurately.

Lifestyle Modifications: Educate G.J. about the importance of a balanced diet rich in calcium and vitamin D, as well as weight-bearing exercises to maintain bone density. Fall prevention strategies should also be discussed to minimize the risk of fractures.

Medications: If osteoporosis is confirmed, discuss pharmacological options such as bisphosphonates or denosumab, which can help strengthen bones and reduce fracture risk.

Patient Education: Provide G.J. with comprehensive information about bone health, risk factors, and preventive measures. Empower her to take an active role in managing her bone health through informed decisions.


In conclusion, musculoskeletal conditions like osteoarthritis can significantly impact an individual’s life. Understanding the condition, its risk factors, and the differences between osteoarthritis and other joint disorders is crucial for effective management. By tailoring treatment approaches, healthcare providers can improve the overall well-being of patients like G.J., addressing their specific needs and concerns.


Alzheimer’s Association. (2019). 2019 Alzheimer’s disease facts and figures. Alzheimer’s & Dementia, 15(3), 321-387.

Bijlsma, J. W., & Berenbaum, F. (2015). Osteoarthritis: an update with relevance for clinical practice. The Lancet, 377(9783), 2115-2126.

Cummings, J. L., & Morstorf, T. (2014). Alzheimer’s disease drug-development pipeline: few candidates, frequent failures. Alzheimer’s Research & Therapy, 6(4), 37.

Hunter, D. J., & Bierma-Zeinstra, S. (2019). Osteoarthritis. The Lancet, 393(10182), 1745-1759.

National Institute on Aging and Alzheimer’s Association. (2011). Alzheimer’s disease facts and figures. Alzheimer’s & Dementia, 7(2), 208-244.

Frequently Asked Questions (FAQs) about Musculoskeletal Function and Neurological Function:

Q1: What is the difference between osteoarthritis and osteoarthrosis?

A1: Osteoarthritis is a degenerative joint disease characterized by the breakdown of joint cartilage and bone, leading to pain and reduced mobility. Osteoarthrosis is an older term for the same condition but is less precise and less commonly used.

Q2: What are the risk factors for osteoarthritis mentioned in the case study?

A2: The risk factors include age (more common in older adults), weight (being overweight increases stress on joints), weather sensitivity, and a family history of musculoskeletal issues.

Q3: How does osteoarthritis differ from rheumatoid arthritis?

A3: Osteoarthritis primarily causes joint pain and involves cartilage deterioration. In contrast, rheumatoid arthritis is an autoimmune disorder characterized by joint inflammation, affecting the synovium lining the joints.

Q4: What are the treatment options for osteoarthritis?

A4: Treatment options include non-pharmacological approaches like weight loss, physical therapy, and assistive devices, as well as pharmacological options such as NSAIDs, acetaminophen, and, in severe cases, opioids.

Q5: How should concerns about osteoporosis be addressed in a patient like G.J.?

A5: Addressing osteoporosis concerns involves bone density assessments, lifestyle modifications (diet, exercise, fall prevention), medication discussion (bisphosphonates, denosumab), and patient education on bone health.

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