group 1 will receive genicular nerve block. The injection and US examination will be done by two experienced sonographers. They were blinded to clinical data. Patients will also be blinded for the injected substance. Each point will be injected with 2 ml of Lidocaine hydrochloride 2 % (Xylocaine, Astrazeneca). The injection will be done using the 3 point technique (superior medial, superior lateral, and inferior medial genicular nerves).

while group 2 received intra-articular triamcinolone under ultrasound guidance and through injecting the supra-patellar bursa.

nerve block of the genicular nerve at 3 points around the inflamed knee using ultrasound.

score to assess ultrasound parameters of the knee including power doppler and grey scale measures

a graded score for pain evaluation filled by the patient graded from 0 to 10

a score to assess knee function. This questionnaire has 8 domains. A score between 95 and 100 means excellent functional performance, good 84-94, fair 65-83 and poor <64

A score graded from 0 to 3; score 0 means no swelling nor tenderness and 3 means maximum swelling and tenderness