Thanks guys!
There seems to be concensus that I will have to remove the engine. I dont have the money for a complete overhaul so will have to look at just replacing this one piston and rod. But, will then have to remove the crank as well to have that checked. Jeeepers this is getting to be a daunting exercise! But I love driving the truck and the knock is hurting me each time. So it will have to be fixed.