instruction: hi doctor I am writing this on behalf of my mother she is 60 years old and weighs about 86 keg her complaint is very extreme pain on the knee left leg this issue started one year ago and we consulted orthopedics who applied an injection on her knee after verifying an ray report and prescribed a couple of tablets doctor said it is a kind of arthritis there was some relief after that visit my mother again started facing the same problem since last month pain is so extreme from inside the knee that she cannot even move her left leg her right leg is fine kindly prescribe some relief and treatment plan please find the written ray reports for your understanding ray both knee joints marginal osteophytes are seen tibial spines are prominent mild reduction of the medial tibiofemoral joint patellar sour is seen no loose bodies are seen in the joint cavities no soft tissue swelling is seen around the joints impression osteoarthritis note she is not taking any medicine for the above issue for the past one year however she is taking tablets for anxiety blood pressure and diabetics
output: hello your rays show grade 3 arthritis is worst in both knees however the ray picture does not always match with the clinical symptom as is in your case I will recommend that you take a course of anti inflammatory tablets like diclofenac 100 my so once a day after meals pantoprazole 40 my before meals tablet ultracet paracetamol and tramadol combination maximum twice daily for pain apply dynapar gel linolenic acid and paracetamol locally four to five times a day ice the knee 10 15 minutes when the spray is not applied that is there had to be a gap of 45 minutes between the ice and spray and vice versa if you have access to physiotherapy then tens transcutaneous electrical nerve stimulation therapy will help too