More Stiffness

A 65 year old lady presents with worsening pain in both knees for 3 years.

She is unable to walk for more than half an hour at a stretch because of the pain, which is exacerbated by kneeling, squatting, or descending the stairs.

Both knees are stiff for around 20 minutes after waking up; the stiffness as well as the pain are relieved by resting.

There is no history of pain, stiffness or restriction of hand movements. Her medical and drug histories are unremarkable.

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ESR & CRP

Realizados

ESR: 11 mm/1h (< 15)
CRP: 0.5 ng/l (< 6)
X-Ray B/L Knee Joints

Realizados

The X-rays of the knees appear normal.
MRI B/L Knee Joints

Realizados

The MRI scan reveals degeneration of the articular cartilage, in combination with subchondral bone changes and marginal osteophyte formation (<5mm in size), in both joints.
Rheumatoid Factor Assay

Realizados

Rheumatoid Factor: negative

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Weight Loss
Acetaminophen
Arthroplasty
Physiotherapy