A 60-year-old woman presents with chronic knee pain on the inside of her right knee, which worsens when climbing stairs or after prolonged sitting. On physical examination, you notice joint line tenderness and mild knee effusion. What might be the issue, and what are your next steps?
The patient's age, location of the pain, and activities that worsen the pain are suggestive of medial compartment osteoarthritis, a common form of arthritis. Weight-bearing X-rays of the knee can help confirm the diagnosis by revealing joint space narrowing, osteophyte formation, and subchondral sclerosis. Depending on the severity, management could include weight loss if overweight, physical therapy, NSAIDs for pain, and possibly intra-articular corticosteroid injections. If conservative measures fail, she may be a candidate for total knee replacement.