Knee pain not relieving with medication

Chief Complaint A 35 y/o female presents with insidious onset right anterior knee pain for 5 months. She was diacharged with the prescription of paracetamol and naproxen regularly. But her pain is getting worse now, medication is not working. History Initial pain 5/10 now increased to 8/10, sharp intermittent pain. Pain is more when using stairs, sometimes she can hear knee cracking, standing after sitting at work for a long time. Investigations X-ray showed nothing abnormal. Active range of movement: Flexion full, Extension full Passive range of movement: Extension - feel slight discomfort, + 10 degrees of hyperextension soft end Resisted range of movement: Flexion - 5/5 no pain Palpation patella tendon reproduces sharp pain. Extension - 5/5 sharp pain anterior knee Treatment Need your valuable advice in treatment planning.

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Consider possibility of Chondromalacia patella Patellar tendon tendinitis like jumpers knee Can differentiate clinically by superficial tenderness or retro patellar tenderness as in grinding Avoid climbing stairs and squatting Rest till pain subsides Quadriceps exercises Analgesics Chymoral Diacerein if chondromalacia patella is suspected Wait and watch for it to get better Don't hurry

? KNEE JOINT ARTHROPATHY.. ? LIGAMENT.. SOFT TISSUE AROUND.. PATELLA ..INJURY.. NEED'S.. MRI STUDY.. PIROXICAM DT.. KNEE SUPPORT.. PHYSIOTHERAPY.. EXPERTS OPINION..

Elevate the leg , by putting one or two pillow under the leg for 30 min to 60 min twice a day for one week. Pillow must be from mid thigh to heel. Avoid long term standing, avoid stairs, avoid squatting as much as possible. Take rest treatment as advised by orthopaedician. After two three days isometric contractions of quadriceps muscle , straight leg raise with ankle stretched to dorsi flexion.. This can be helpful......

It also seems meniscus injury ,just do proper phtsical examination by physio or ortho..ask her to avoid psinfull movt..for chrindo malacia ,cross leg squating must be also painful but normal sitting extension dont elicit pain generally except if swelling is there..you can have patella skyline view x ray for it..hope it helps

It also seems meniscus injury ,just do proper physical examination by physio or ortho..ask her to avoid painfull movt..for chrondo malacia ,cross leg squating must be also painful but normal sitting extension dont elicit pain generally except if swelling is there..you can have patella skyline view x ray for it..hope it helps

Could be chondromalasia patella. Please post x rays sir.

It could be Osteochondritis dessicans patella.

Is she into any sports or physical activity

Patellar tendinitis Rest Physiotherapy