Nonpainful Enlargement of the terminal joint

A 56-year-old woman presents to her doctor’s office complaining of gradually progressive, nonpainful enlargement of the terminal joint on her left hand over a 9-month period. She has some stiffness with typing but not first thing in the morning. She also reports pain in her right knee, which occasionally “locks up.”

The right knee also hurts after long walks. On examination, her blood pressure is 130/85 mm Hg, heart rate is 80 bpm, and weight is 285 lb. Examination reveals only a nontender enlargement of her left distal interphalangeal (DIP) joint, and the right knee is noted to have crepitus and a slightly decreased range of motion.

There is no redness or swelling.

What is your educational, non-pharmacological, and pharmacological plan?