A troublesome knee

Non-surgical management should be first line for a number of joint conditions

Rita is a 65-year-old retired teacher. She remains active, walking for 30 minutes every day and spends time in her garden.

She presents to her GP later in the day explaining that over the past few months, she has noticed increasing pain at the medial aspect of her left knee.

The pain gradually worsens the longer she is on her feet, and is sometimes associated with sharper pains and a catching sensation. When asked, she says she has not noticed any swelling.

Rita is overweight, with a BMI of 26. Focused clinical examination shows her left knee is