A 65-Year-Old Man Comes to the Office Due to Intermittent

A 65-year-old man comes to the office due to intermittent right knee pain for the last 3 or 4 months.  The symptoms are worse at the end of the day, and he has had mild swelling at the knee following strenuous exertion.  There is no associated fever, malaise, or rash.  The patient takes metformin for type 2 diabetes mellitus.  BMI is 36 kg/m².  On examination, the right knee has bony enlargement and a small effusion but no warmth or erythema.  Range of motion elicits pain.  Analysis of synovial fluid obtained via arthrocentesis shows a leukocyte count of 1,800/mm³ with no crystals.  Serum creatinine is 0.8 mg/dL and serum uric acid is 5.6 mg/dL.  In addition to a supervised exercise program, which of the following medications is the most appropriate for relief of this patient's symptoms?

A) Acetaminophen with oxycodone
B) Colchicine
C) Diclofenac
D) Febuxostat
E) Prednisone

Correct Answer:

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