Dr. Rama Chauhan (General Practice) needs a second opinion on this medical case.
64 y/o female presents with bilateral knee pain, but more on the right side. She also noted mild swelling which is present with pain, and sometimes she had knee stiffness in the morning.
History for right knee pain dated back to 3 years, it has gotten worse over the last 6 months & she also noted similar pain on the left knee.
She is obese & has h/o diabetes type II, COPD & CKD.
BP: 155/97 mmhg, Heart rate: 95 Bpm, Respiratory rate: 17 Bpm
She has some stiffness in bothe knees with tenderness on palpation to medial joint lines of both knees, which is more on right side. There is a trace effusion of the right knee, none on the left.
What should be the management for her knee pain?