Dr. Hansen, an orthopedist, is seeing Andrew, a 72-year-old established male patient today who has complaints of severe knee pain in both knees and repeated falls over the past 2 months. Dr. Hansen completes a detailed history and exam with medical decision making of moderate complexity, including standing, anteroposterior X-rays of each knee standing, which show worsening osteoarthritis. Because the patient has been experiencing repeated falls, Dr. Hansen provides the patient with an adjustable tripod cane with instructions for safe use. Dr. Hansen recommends the patient begin taking OTC glucosamine chondroitin sulfate, anti-inflammatories for pain as needed, and schedules the patient for a follow-up appointment in one month.
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