Rachel presents with knee pain that worsens with activity and improves with rest. She describes stiffness lasting about 30 minutes in the morning and difficulty with stairs. On examination, there is mild joint swelling and crepitus with knee flexion and extension. Which examination finding is MOST indicative of knee osteoarthritis?

A) Positive McMurray test

B) Reduced knee flexion range of motion

C) Medial joint line tenderness

D) Presence of effusion

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