What would cause very localized tingling in outer knee cap? the sensation happens when i bend inward or outward.

Compression of senso: this can cause by compression of sensory nerve in the groin called meralgia parasthetica , can be diagnosed by NCV nerve test , treated with wearing loss cloths ,no belt, steroid injection will relive the symptoms

Localized tingling in outer knee cap: Have you ever had an injury of the knee, such as in a MVA, or a bad fall, other similar event? have you seen a Dr? have you had imaging studies of the knee? The lesion you are describing is related to a cartilage loss, which an MRI should confirm. I would take an anti-inflammatory medication, Duloxetine 30 mg./ twice a day. Works for pain, depression, and fibromialgia, you may add Aleve (naproxen) 1 x 2/day