Patient presents with chronic joint pain consistent with a diagnosis of primary osteoarthritis involving multiple joints.  Symptoms reported include pain, stiffness, crepitus, and reduced range of motion affecting the bilateral knees, hands (specifically the distal interphalangeal and proximal interphalangeal joints), and hips.  Onset of symptoms has been gradual over several years, with progressive worsening impacting activities of daily living.  Patient denies any history of trauma, infection, or inflammatory arthritis.  Physical examination reveals bony enlargement of affected joints, tenderness to palpation, and limited mobility.  Radiographic imaging confirms the presence of osteophytes, joint space narrowing, and subchondral sclerosis, consistent with osteoarthritis.  Laboratory tests, including erythrocyte sedimentation rate and C-reactive protein, are within normal limits, ruling out inflammatory arthropathies.  Assessment: Primary osteoarthritis involving multiple joints (ICD-10-CM code M15.0).  Plan:  Conservative management including regular exercise, weight management counseling, physical therapy focused on strengthening and range of motion improvement, and over-the-counter analgesics such as ibuprofen for pain management.  Patient education regarding osteoarthritis management, joint protection strategies, and assistive devices will be provided.  Follow-up scheduled in three months to assess symptom progression and treatment efficacy.  Consider intra-articular corticosteroid injections or referral to orthopedics for surgical intervention if conservative measures fail to provide adequate symptom relief.