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Table 1 Summary of the SCS recommendations in each step [11]

From: Agreement of general practitioners with the guideline-based stepped-care strategy for patients with osteoarthritis of the hip or knee: a cross-sectional study

 

Step 1

Step 2

Step 3

Diagnostic procedures and assessment

 - Medical history and physical examination

 - Radiological assessment*

 - Consultation specialist

 - Assessment function and activity limitations

 - Assessment of pain coping and psychosocial factors

 - Adjust goals

 - Setting mutual goals

 - Adjust goals

Treatment modalities

 - Education

 - Exercise therapy

 - Multidisciplinary care

 - Lifestyle advice

 - Dietary therapy

 - TENS

 - Medication

 - Medication

 - Medication

  ∙ Acetaminophen

   ∙ (topical) NSAID’s

  ∙ Intra-articular injections

  ∙ Glucosaminesulphate

  ∙ Tramadol

Evaluation

 -After 3 months

 -After 3–6 months

  -Patient sets interval

  1. Abbreviations: SCS = stepped care strategy; NSAIDs = Non-Steroidal Anti-Inflammatory Drugs.
  2. * If there is a discrepancy between medical history and physical examination.
  3. Consult current guidelines for an adequate dose.
  4. Or earlier if the symptoms persist or increase.