Case study: Knee osteoarthritis – Injection
A 60-year-old female patient complains of persistent right knee pain lasting for more than six months. She experiences significant pain over the anterior and medial aspects of the knee, which worsens when she stands or squats. Taking NSAIDs offered some relief. She has no prior history of trauma, and her BMI is 30.
Physical examination
- No swelling, warmth, or redness of the knee
- Crepitus on flexion and extension of the knee
- No deformities
- Minimal quadriceps wasting
- Normal gait
Ultrasound findings
- Quadriceps tendon: Normal, small effusion in the suprapatellar recess
Long axis view of the quadriceps tendon, which appears normal. A small effusion is seen in the suprapatellar recess.
- Medial meniscus: Extrusion
Long axis view of the medial meniscus showing an extrusion.
- Patellar tendon: Normal
Long axis view of the patellar tendon, which appears normal.
- Iliotibial band: Normal, small lateral meniscal cyst, likely not causing any pain
Long axis view of the iliotibial band, which appears normal. A small lateral meniscal cyst can be seen.
Diagnosis
The patient was diagnosed with grade 3 knee osteoarthritis. Knee osteoarthritis, a condition commonly observed in the elderly, is categorized into primary (idiopathic degeneration) and secondary (due to factors like trauma, obesity, or rheumatoid arthritis). Typical symptoms encompass gradually worsening knee pain, stiffness, swelling, and a crackling sensation known as crepitus.
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