Pain While Kneeling, MRI, Moderate Contusion, Lateral Femoral Condyle, Knee Effusion, Medial Meniscus
From the information you submitted and the imaging findings you have shared I don't think an immediate referral to a specialist will be of any benefit.
Right now you have some inflammatory changes in the knee which can be addressed with a couple of options.
I have a few recommendations regarding management of the symptoms you are currently experiencing.
The first angle of potential therapy would be to start and aggressive anti-inflammatory regimen. I would suggest you consider taking something like ibuprofen 800 mg three times per day. This would involve taking four of the over-the-counter tablets every eight hours. If ibuprofen is not adequate or not a good choice for you due to side effects or intolerance. I would suggest using a leave or Naprosyn. Naprosyn can be used twice daily call of the over the counter variety. These medications will help promote healing as well as can improve the fluid effusion within the knee joint. I would try this regiment for at least the next 10 to 14 days before reassessing how you feel.
In addition, it looks like we need to try to limit the amount of stress that your knees and door on a daily basis. From the information you have submitted it looks like you may be moderately above and ideal weight. Have you tried or considered a gradual weight loss program? This would involve a multidisciplinary approach with both diet and exercise. A dietitian or someone with good knowledge of high energy and low calorie foods may be of significant help for you. This is just a side consideration.
I really don't think you need to worry about any immediate referral as I mentioned previously. I don't think you're in any significant danger of really hurting your knee. For the time being I would suggest the anti-inflammatory regimen as well as limiting any heavy lifting or exercise which would put stress on the knee. Over a long term you could consider the weight modification as I suggested as well.
Thank you again for submitting your query. I hope you have found my answer to be both informative and helpful. If you have any additional concerns regarding this question I would be happy to address them.
Sincerely,
Dr. Robert.