A 65-year-old white man presented to his primary care provider complaining of right knee pain and stiffness especially after rising from bed in the morning. The patient indicated that the pain began approximately two months previously and had gotten progressively worse. The patient indicated he had been unable to complete his normal running and weightlifting program because of the pain. His knee also had often swelled after activity. The pain and swelling were partially relived by ibuprofen. The patient had been taking a glucosamine/chondroitin combination product for the last three weeks and wanted to know if the provider thinks this will help him.
Physical examination revealed a varus alignment of the knees with a mild effusion of the right knee. There was tenderness to palpation of the anteromedial joint line. Range of motion was 3 to 120 degrees in the right knee compared with 0 to 120 degrees in the knee. There was pain with full flexion and extension of the right knee. Standing anteroposterior X-rays revealed a mild medial compartment joint-space narrowing bilaterally, with the right greater than the left. Sunrise view revealed medial and lateral osteophytes at the patellofemoral inner space in the right knee and a medial osteophyte in the left knee.