Brief Answer: Clinical review, MRI, orthopedic surgeon Detailed Answer: Hi and thanks for the query, There are two main possibilities. First, a chronic inflammation at the level of the bursi ( fluid containing membranes at the level of the knees), inflammation of these membranes could lead to fluid collection within them and swelling. Secondly, a chronic inflammation or related structures like muscles, tendons and ligaments. The first step in the management process is simply by using appropriate anti inflammatory drugs. Injectable Diclefenac for a week could be sufficient. A clinical review revealing fluid collection at the bursi would require draining of the fluid, and subsequent intra articular injection of steroids in case of need. Your age however makes a history of gout very unlikely. A proper clinical review is imperative and these initial measures are usually sufficient. In case of doubt or non improvement, the opinion of an orthopedic surgeon wold be needed. A scan and a Magnetic rasonance Imaging image (MRI) would be the gold standard for appropriate diagnosis and guidance of further medical or surgical care. Thanks and kind regards. The opinion of your primary care physician, and probably an orthopedic surgeon, in case of need would be ,most welcome. Dr Bain

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Brief Answer: Diclofenac , opinion of your orthopedic/family doc Detailed Answer: Hi and thanks for the query, I think starting with drugs like Diclofenac 75mg, one tablet twice daily and using Diclofenac creme, applied twice daily to the knee could offer much help. However, the opinion of your doctor and possibly the orthopedic physician still remains very important. Kind regards

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