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Clinical Review Interactive case report

A 64 year old woman with knee pain: case progression

BMJ 2004; 328 doi: (Published 10 June 2004) Cite this as: BMJ 2004;328:1425
  1. P Tugwell (, professor of medicine1,
  2. A M O'Connor, senior scientist, clinical epidemiology2,
  3. N A Santesso, knowledge translation specialist3
  1. Department of Medicine, University of Ottawa, 202-1 Stewart Street, Ottawa, Canada, K1N 6N5
  2. Ottawa Health Research Institute, Ottawa Hospital, 1053 Carling Avenue, Ottawa, Canada, K1Y 4E9
  3. Cochrane Musculoskeletal Review Group, University of Ottawa
  1. Correspondence to:

    Last week (5 June, p 1362) we presented the case of a 64 year old woman who was concerned about taking paracetamol (acetaminophen) after reading that it could cause liver damage when taken with alcohol at the high doses she required to control her knee pain. Her general practitioner had discussed with her the benefits and harms of paracetamol versus non-steroidal anti-inflammatory drugs, but she felt she needed more information and time before making a decision.

    Her general practitioner gave her a patient education decision aid package about paracetamol and non-steroidal anti-inflammatories for osteoarthritis.1 He told her that this material describes the best evidence available today about the benefits and harms of both drugs and would help …

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