A 58 year old female presents with chronic knee pain, specifically on the medial side of her knee. Radiographs are shown below. Help in diagnosing the case and its management.



There is a osteochondroma like lesion sitting on the medial condyle of the femur. Please see of that is the cause. If it's localising there try conservative approach like local steroid injection for any bursitis and Kindly put her through a supervised Physio. Reassess and proceed.

Medial compartment OA knee Patellar tracking okay An exostosis on the medial femoral condyle Likely to produce pressure effects on ligaments and tendons May have an adventitious bursa over it Analgesics Chymoral Calcium vitD Diacerein will help Physiotherapy Consider excising the exostosis

?osteochondroma on medial femoral condyle / ?ossification of upper end of medial collateral ligament

The pain may be due to bursa formation over the bony swelling on the medial condyle of femur.it needs to be excised

Pellegrini-stieda lesion.

Why to jump directly to surgeries and injection. @Vinay Verma sharmahe is right. Lets first treat this conservatively . Then we can add strengthening of knee muscles spl. VMO .

If there is localised tenderness over the osteochondroma like growth from med. femoral condyle and CRP is within normal limit, excision and biopsy may be the choice.

Differentials: Pelligrini-Stieda syndrome, Calcific tendinosis, Medial collateral ligament sprain

Go with physiotherapy management .... T. E. N .S . with in 12min.. With hot pack and ultrasonic therapy in medial side of the knee and set intensity 1.2 in continues mode.... Tens... To reduce the pain and stimulate the nerve and increase blood flow. Ultrasonic therapy..... It's use to healing purpose.... Hot pack... To reduce swelling...

Excersise should be started after with in 1 weak .... 1.. Ankel toe pump movement in 10 time 2... Heal slide.... Both knee in 10 time. 3.... Straight leg raising(SLR) with hold both knee in 10 time. 3.... Isometrics excersise of the calf and hams... Both knee with in 5-5 time.... 4..... Manual traction of the knee with anterior gliding of the knee .. 5.... Stechings in calf and hamstring muscle with in 2-2 time of both legs. 6.... Vibrator of both legs in posterior side of hamstring and calf muscles with in 5 mint.......

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