**Core Concept:** Osteoarthritis (OA) is a degenerative joint disease characterized by the breakdown of articular cartilage and subchondral bone, leading to pain, stiffness, and reduced mobility. It is a common cause of knee pain, especially in older adults. The management of knee OA aims to alleviate symptoms, maintain joint function, and delay progression of the disease.

**Why the Correct Answer is Right:** The recommended line of management for a patient with a history of pain and swelling in the knee due to osteoarthritis involves a combination of pharmacological and non-pharmacological options. In this case, the correct answer (D) refers to a combination of pharmacological and non-pharmacological options.

**Why Each Wrong Option is Incorrect:**

A. Surgery (OA is not an indication for major joint replacement unless there is significant joint deformation or severe disability, as it is a chronic condition with slow progression).

B. Radiological evaluation alone (This option does not address the symptoms and functional improvement of the patient).

C. NSAIDs (Non-steroidal anti-inflammatory drugs) are beneficial for pain relief and reducing inflammation in OA, but may not be the sole treatment option for a patient with severe disability and impact on ADL (Activities of Daily Living) due to pain and swelling.

D. Includes both pharmacological (NSAIDs) and non-pharmacological interventions (physiotherapy, weight loss, and joint protection) to address the pain, swelling, and functional impairment caused by the patient's knee OA.

**Clinical Pearl:** In the management of knee OA, a multidisciplinary approach involving pharmacological and non-pharmacological interventions is essential to address pain, swelling, and functional impairment, as well as promoting overall patient wellbeing and quality of life. A combination of NSAIDs, physiotherapy, weight loss, and joint protection is recommended for severe OA cases, as in this question.