Sometimes vmo pain can be caused from atrophied quad.
Did you have time off and go back to riding?
Or increase mileage recently?
You may have increased mileage too fast.

Are you working up/down stream of the issue?
Hip and ankle?
Do you have full range of motion in the knee?
Do your knees go forward first when you squat?
Wonky, Beat Up Joint? Feed That Thing Good Mechanics and Some Slack