A 60-year-old, mildly obese woman presents complaining of bilateral medial right knee pain that occurs with prolonged standing. The pain does not occur with sitting or climbing stairs but seems to be worse with other activities and at the end of the day. The patient does not have morning stiffness but her knees are stiff after sitting for a long time. Examination of the knees reveals no deformity, but there are small effusions. Some mild pain and crepitus are produced with palpation of the medial aspect of the knees. Which of the following is the most likely diagnosis? a. Rheumatoid arthritis b. Gouty arthritis c. Chondromalacia patellae d. Osteoarthritis e. Psoriatic arthritis
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