<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 52-year-old woman comes to the physician because of a 3-week history of pain in her right knee. The pain is worse at the end of the day and when she walks. She says that it has become difficult for her to walk up the flight of stairs to reach her apartment. She has hypertension and psoriasis. Her sister has rheumatoid arthritis. She drinks 23 beers daily. Current medications include hydrochlorothiazide, topical betamethasone, and a multivitamin. She is 160 cm 5 ft 3 in tall and weighs 92 kg 202 lb; BMI is 36 kgm2. She appears anxious. Her temperature is 37C 98.6F, pulse is 87min, and blood pressure is 13583 mm Hg. Cardiopulmonary examinations shows no abnormalities. There are several scaly plaques over the patients upper and lower extremities. The right knee is not tender nor erythematous; range of motion is limited. Crepitus is heard on flexion and extension of the knee. Her hemoglobin concentration is 12.6 gdL, leukocyte count is 9,000mm3, and erythrocyte sedimentation rate is 16 mmh. An x-ray of the right knee is shown. Which of the following is the most appropriate next step in the management of this patient?? A: Intraarticular glucocorticoid injections, B: Weight loss program, C: Total joint replacement, D: Methotrexate therapy, E: Colchicine therapy,  <response>: Based on the information provided in the question stem, this appears to be a case of osteoarthritis of the right knee in a 52-year-old woman. The key findings are:- 3-week history of right knee pain, worse at end of day and with walking - Difficulty walking up stairs- Physical exam shows limited range of motion, crepitus on flexionextension- X-ray shows joint space narrowing and osteophytes, consistent with osteoarthritis- Relevant history includes obesity BMI 36, family history of rheumatoid arthritis- Lab tests are relatively unremarkableThe next step in management should focus on symptomatic relief through conservative measures. Total joint replacement would be premature at this stage. Methotrexate and colchicine are used for inflammatory types of arthritis like rheumatoid arthritis, not osteoarthritis. B: Weight loss program 