Systemic Oral Glucocorticoids for the Treatment of Acute Osteoarthritis Pain in the Emergency Department

Inclusion Criteria: * Age ≥18 years * Acute monoarticular arthritic joint pain affecting native knee, hip, or shoulder presumed to be related to osteoarthritis * Acute pain above baseline starting less than 72 hour prior to ED visit * Planned discharge from the ED * History of osteoarthritis of the affected joint based on radiography performed at index visit or prior available imaging Exclusion Criteria: * Trauma to the affected joint within 30 days * Injection of affected joint within 60 days * Prior arthroplasty of the affected joint * History of coronary artery disease, severe gastrointestinal bleeding, gastric/peptic ulcer disease, chronic kidney disease with GFR less than 30, or platelet disorders (including von Willebrand disease, hemophilia, severe thrombocytopenia with platelets less than 50 k/mcL) * Joint pain suspected to be related to rheumatoid arthritis, gout, septic arthritis, or other non-osteoarthritis autoimmune/inflammatory/infectious arthritis * Chronic/baseline use of glucocorticoids (greater than 5 mg daily prednisone or equivalent within previous 7 days) or NSAIDs (daily use for more than 2 days prior to presentation) * Daily prescription opioid use or active opioid use disorder * Illicit drug use * Known allergy/intolerance to ibuprofen/NSAIDs, prednisone, dexamethasone, or other medication precluding ability to participate in one or more study arms * Other contraindications to ibuprofen/NSAIDs or glucocorticoids * Planned hospitalization from the ED * Pregnancy * Incarceration * Inability to provide informed consent * Other conditions that would preclude compliance with the study protocol and medication dosing