What causes severe pain and swelling in the knees and elbows of a diabetic 54-year-old female?

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Considering her age and your description, she seems to be having osteoarthritis of the knee. This is a wear and tear process of the joint and is often age-determined. Other factors like weight, diabetes, and so on play an additional role in prevalent symptoms. Pain occurs due to the loss of smooth cartilage support of the joint with resultant debris causing inflammation, swelling, and warmth, all leading to pain often while walking especially after rest and sometimes, pain can occur even at rest as the disease progresses.

Initial management strategies include weight loss, regular exercise to help strengthen the muscles, analgesic tablets, non-steroidal anti-inflammatory drugs (NSAIDs), injections, and so on. She will need X-rays at some stage to assess the grade of osteoarthritis. Based on the X-ray and response to the initial treatment, a future treatment plan can be made.

I hope this helps. Do get back if you have any further queries.

Thank you.