For a 49-year-old migrant worker with progressive left-hip OA affecting daily activities, what is the most appropriate management plan?

• A. Oral acetaminophen
• B. Oral muscle relaxant
• C. Acetaminophen and physical therapy
• D. Oral NSAID and referral to orthopedics

Answer: (D)

In hip osteoarthritis with progressive symptoms that disrupt daily life, the goal is both effective pain relief and assessment for potential surgical intervention when conservative measures fail. Nonsteroidal anti-inflammatory drugs provide stronger pain and inflammation relief for hip OA than acetaminophen alone, helping the patient regain function. At the same time, persistent functional impairment despite medical management warrants a surgical evaluation to consider options such as hip replacement, especially in a relatively young patient with ongoing decline. So using an NSAID for symptomatic relief plus referral to orthopedics for possible surgical management addresses current pain and future function more comprehensively than the other plans.