Review Question - QID 210280

An 18-year-old girl comes to your office complaining of deep, ill-defined bilateral knee pain for years. The pain becomes worse during long car rides. It is also worse when getting out of a deep-seated position and descending stairs. She recalls no injury. She was seen by her PCP and sent for 4 weeks of physical therapy focusing on closed chain quadriceps strengthening exercises, but the pain has persisted. She has a normal ligamentous examination with no evidence of meniscal pathology and no effusion. Her images are shown in figure A. What is the next step in management?