Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, progressive bilateral knee pain, worse with weight-bearing activities and prolonged standing. Reports morning stiffness lasting <30 minutes, occasional mechanical symptoms including crepitus and intermittent joint swelling. Pain is exacerbated by stairs and squatting, partially relieved by rest and NSAIDs. No history of trauma, fever, or constitutional symptoms.
Clinical Examination Findings
Bilateral knees: Inspection reveals mild varus/valgus deformity, no erythema or significant effusion. Palpation demonstrates joint line tenderness medially and laterally. Range of motion is limited by pain at terminal flexion. Crepitus noted on passive ROM. Ligamentous stability (ACL/PCL/MCL/LCL) intact. Neurovascular status distal to knees is intact.
Treatment Protocol
Plan: 1. Weight management and physical therapy for quadriceps strengthening. 2. Activity modification to low-impact exercises. 3. Oral NSAIDs as needed for pain control. 4. Consider intra-articular corticosteroid or hyaluronic acid injections if conservative measures fail. 5. Follow-up imaging (X-ray weight-bearing views) to monitor joint space narrowing.