instruction: hello doctor two months ago my mother fell down on her knees but did not seem to complain recently she did a bit of house work for a few days and her knee is in pain especially in the back where you bend your leg pain is also notable when she sits down for an hour or longer and gets up and also when waking after sleep
output: hello your mother has osteoarthritis of the knee and the fall may have stirred this further the pain that you describe is at the back of the knee this can come from the knee cap as well as the degenerative tear of the medial meniscus as there are a very little mechanical symptom like locking and giving way not there is much of an effusion I feel that the pain is from the knee cap the pain in such cases can be at the back of the knee pain is worse in climbing stairs or coming down worse after having sat down for any length of time this condition is called patellofemoral compression syndrome and can be helped with regular exercise and patellar gaping and a course of anti inflammatory medications like diclofenac or piroxicam in addition she can take paracetamol and tramadol combination for pain she will need to do vmo gluteal core strengthening exercise and hamstrings stretches in addition she needs to avoid squatting the physiotherapist can in addition give ift or tens to help it will take 6 months for the pain to settle down mri also shows an incarcerated needle tip under the patella have but I need to have this physically checked if this was recent and was it from the fall on to a sharp object