Role of Methotrexate in Ultrasound Proven Synovitis in Primary Knee OA

One group will receive MTX, starting with 15 mg per week for the first 2 weeks then increase to 20 mg and continue for the remaining period if tolerated. another group will receive placebo

The investigational drug and the placebo will be formulated to be identical in appearance, packaging, labeling. Blinded study medications will be prepared, packaged, and labeled by the sponsor according to Good Manufacturing Practice (GMP) standards. All packaging will use neutral labeling with unique subject numbers only.