MBBS OSCE · General Medicine
OSCE — Osteoarthritis
Eight-minute OSCE station on Osteoarthritis: focused history, examination priorities, investigations, emergency and definitive management.
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Brief (to candidate)
You will assess a patient with a presentation consistent with Osteoarthritis.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Osteoarthritis (OA) is the commonest joint disorder — a degenerative, mechanically driven arthritis of articular (hyaline) cartilage with bony remodelling (osteophytes, subchondral sclerosis and cysts), meniscal damage and low-grade synovial inflammation. It predominantly affects the knees, hips, hands (DIP — Heberden nodes, PIP — Bouchard nodes, first CMC) and spine. Risk factors are age, obesity, female sex, prior joint injury, repetitive occupational stress and genetics. It presents with use-related joint pain (worse with activity, better with rest, brief morning stiffness under 30 minutes), functional limitation, crepitus and bony swelling, with late deformity. Diagnosis is clinical, sup
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.
- State focused examination priorities.
- List first-line investigations and any named score/criteria.
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).
- Mention one special-population modifier (pregnancy, child, elderly, CKD).
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Definition | Correct working diagnosis language |
| Assessment | Focused, prioritised, red flags sought |
| Investigations | Appropriate first-line + interpretation |
| Emergency care | ABC / time-critical actions first |
| Definitive care | Specific drugs/procedures, not generic phrases |
| Safety | Use-related joint pain with brief morning stiffness under 30 minutes, bony swell |
| Safety | Sudden worsening, night pain or rest pain in a previously stable osteoarthritic |
| Safety | Hot, swollen knee with severe pain and systemic features — septic arthritis or g |
| Communication | Clear plan and safety-netting |
Model outline
Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.