25/f/chronic knee pain....clicks.no effusion or instability...Work up? management?

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Thinking of marked Osteoarthritis in a 25 yrs. old patient is something not very palatable, more so in absence of any contributory cause, such as trauma or pre existing chronic arthritic condition. Conditions such as chondromalacia patellae or meniscal pathologies should be ruled out by CT or MRI scan first and management to be done accordingly.

Osteoarthritis with Osteophytes formation- reduction in jt space. Along with supra patellar synovitis. MRI will be much more focus on intra- articular lig. Injury. Its seems to be meniscus injury anterior horn. Instead Immediate of TKR I think conservative treatments should start with Glucosamine- diacertan- chondroitin phosphate. NSAID with Enzyme - Nervine tonic. I think TKR should be last option as as per age factors is concern will respond conservative treatments with physiotherapy.

Osteoarthritis with Osteophytes formation- reduction in jt space. Along with supra patellar synovitis. MRI will be much more focus on intra- articular lig. Injury. Its seems to be meniscus injury anterior horn. Instead Immediate of TKR I think conservative treatments should start with Glucosamine- diacertan- chondroitin phosphate. NSAID with Enzyme - Nervine tonic. I think TKR should be last option as as per age factors is concern will respond conservative treatments with physiotherapy.

Advanced osteoarthritis at such early age not reasonable !! Get MRI and arthroscopy and if same pathology then go for high tibial osteotomy !! May need knee replacement later on !! Also check if its unilateral or bilateral to ascertain cause

Will High tibial osteotomy work in pan arthritis?
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It will be cured without replacement....only on conservative treatment

Severe OA.Can occur in overweight individuals irrespective of age

Total loss of joint space: partially might be fused: TKR

Any History of meniscectomy/ infection/ autoimmunity?

No
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Very bad osteoarthritis.sugested knee replacement.

Also TB? What about x ray of other knee?

No TB ..other knee asymptomatic..
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