Maryia (71 years old)

Maryia is a 71-year-old retired librarian with OA (coxarthrosis) but no history of diabetes mellitus nor hypertension.

When she was diagnosed with OA 4 years ago, you advised lifestyle changes. Following your advice, she stopped smoking after 30 years, changed her diet, and was more physically active. As a result, she also lost weight.

However, due to increasing joint pain (visual analogue scale [VAS] >6), she stopped exercising in the past 1.5 years, which resulted in weight gain to a BMI of 31. Additionally, her motility diminished and she also started suffering from reduced flexion, extension, and abduction of the hip.

Due to insufficient pain control with 3 g paracetamol/day, Maryia has been self-administering frequent courses of over-the-counter NSAIDs in the past 6 months. A recent hip X-ray shows advanced coxarthrosis of both hips, accentuated on her right side.

She comes now to your practice as the pain has become uncontrollable due to OA progression and is affecting her quality of life.