DX, Mx - Osteoarthritis/? Osteomalacia

76/F HTN/DM/Hypothyroid Pain both knee+hip, decrease ROM, no local inflamm. Xray: age related degeneration Osteoarthritis/?Osteomalacia 25-OH-VitD: 20.4( decrease ) DX, Mx?

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Severe osteoarthritis both knees as degenerative changes with osteophytes and decreased articular spaces are evident LS region also shows osteophytes and lumbar spondylitis with osteoporosis

Thank you doctor
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Tricompartmental OA knee bilateral Will benefit from bilateral TKR Listhesis grade 1 L5/S1 Lumbosacral corset Calcium vitD Gabapentin will help

Thank u so much sir
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Degenerative changes in spine with osteophytes.L2,L3,L4 not aligned( increased lateral curvature) probably due to structural changes in the spine,L5-S1 lysthesis, Sacroiliac joints and the levels of ilium not clear .

Physiotherapy evaluation, assessment of ROM(active,passive)of all the limbs along with spine flexion,extension .Flexion,rotation exercises only after assessment and core muscle strengthening. Spinal alignment gradually with manual therapy or Chiropractic adjustor. The tight paraspinal muscles on one side also need to be relaxed along with strengthening of other side muscles. But the SI joint,knee n foot,upper limb alignment important to assess

B/l O.A. knee with degenerative changes and osteophytes,medial compartment more involved,