Knee osteoarthritis
Knee osteoarthritis is a common cause of stiffness, pain with walking or stairs, reduced confidence in activity and flare-ups after loading. Symptoms often come from a mix of cartilage wear, synovial irritation, bone sensitivity, muscle weakness and reduced tolerance to load.
Common symptoms
- Pain around the front, inside or general knee joint
- Start-up stiffness after sitting, especially in the morning
- Swelling or a sense of fullness in the joint
- Pain on stairs, hills, squatting or longer walks
- Loss of confidence, reduced activity and deconditioning
What assessment involves
- Detailed history of pain pattern, aggravating activities and previous treatment
- Examination of range of movement, swelling, gait, strength and balance
- Assessment of hip, ankle and general lower-limb loading strategy
- Diagnostic ultrasound when it changes management, for example to assess effusion, Baker's cyst or other soft-tissue contributors
Treatment options
- Education and load pacing during painful flare-ups
- Progressive strength work for quadriceps, gluteals and calf
- Mobility and range restoration where needed
- Weight-management advice where relevant
- Pain-relieving strategies to keep rehabilitation moving
- Injection discussion, including corticosteroid or hyaluronic acid, only when clinically appropriate
When injection may be discussed
- Persistent inflammatory flare limiting rehabilitation
- Significant pain affecting sleep, walking or work
- Patient has already trialled appropriate rehabilitation but still has a pain barrier
- Goal is symptom control to allow better exercise progression rather than replacing rehab
When to get assessed
Assessment is useful if symptoms are persistent, recurring, limiting work or sport, or if you are unsure whether physiotherapy, imaging or injection is the most appropriate next step.
How ultrasound can help
Ultrasound is not automatically required for every patient. It is most useful when it will change management, improve diagnostic confidence or guide treatment safely.
Where injection fits
Injection is considered only where clinically appropriate after discussion of risks, benefits and alternatives. The aim is usually to reduce pain enough to progress rehabilitation, not to replace rehabilitation.