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Arthritis of knee, 54 years - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Arthritis
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2126 Questions
User :   Hi, my mother has developed a pain in the knee, she is 54 years of age, an orthopedic has said that the bone in growing, that its arthritis, can u tell me the precautions to take and the medication? is it curable?
Doctor :   Hi
Doctor :   I need a few details about your mother.
User :   sure
Doctor :   May I know how much she weighs, her height,
Doctor :   Occupation,
User :   her weight is 72 kgs it has been the same for past few years, her height is 5.5 ft...
User :   she is a house wife....she does all the house work by herself.....
Doctor :   Does she have any other medical problems?
User :   she had a uterus removal operation 2.5 yrs back, other than that , she had minor cynus problem...
Doctor :   Since when is she suffering the current problem?
User :   other than this she has no other problems
User :   she has having pain from the past 7-8 days,
Doctor :   You said "the bone in growing, that its arthritis".
User :   yes
Doctor :   Is it the bone is growing or bone in growing?
User :   what is the difference?
User :   doctor said that "haddi badh rahi hai"...there is no change in the shape of the knee...but crackling sound can be heard int he joint...when she bends the knee...
Doctor :   In growing bone means that the bone is encroaching the joint space
Doctor :   Ok, 7 to 8 days is an acute problem
Doctor :   Has she ever had it earlier?
User :   yes, some 12 years back she had minor pain for 1-2 months in the knee...
User :   it went away by itself...
Doctor :   Is she having other symptoms like fever, swelling of joint etc along with this?
User :   no, she has no fever or swelling
Doctor :   OK
Doctor :   Then this could mean 2 thingfs
Doctor :   It is too early to predict exactly
Doctor :   It could either be an acute problem- inflammatory arthritis(due to sudden or occasional strain on the knee)
User :   ok..
Doctor :   In which case it will heal in a week, provided proper rest & physiotherapy is given.
User :   ok..
Doctor :   Or it could be the beginning phase of a chronic disease called Osteoarthritis(disease associated with increasing age)
Doctor :   In which case the problem will be a lifelong one, requiring continuous treatment & care.
Doctor :   For either of these, rest during the Attack
Doctor :   & exercise on relief(when there is no pain)
Doctor :   Knee strengthening exercises & weight loss will help a lot.
Doctor :   Analgesics(pain killers), not only relieve the pain during the attack, but also reduce the inflammation(tissue damage/reaction)
User :   ok..
Doctor :   Consult with a Knee Clinic, which is available in hospitals like Apollo & Manipal.
Doctor :   Avoid climbing downstairs, can climb though
Doctor :   Evening or morning walk
User :   ok..
Doctor :   Hot water/bag fomentation before the walk/exercise & Cold water/bag fomentation after it
User :   how do we differentiate now, if it is osteoarthritis of inflammation one?
Doctor :   Make sure you get all the tests suggested by orthopedician is done, so that other less common diseases of knee are ruled out
Doctor :   Time will clearly delineate the difference
User :   what are the tests to be done? can u tell me plz?
Doctor :   Right now it has to be treated considering it to be an acute disease
User :   ok, wat is the treatment for that?
Doctor :   RA factor, Tests for SLE(antibodies), Other antibodies of rarer connective tissue diseases etc..
Doctor :   Now she must take Analgesics
Doctor :   rest
Doctor :   physiother
Doctor :   Hi
Doctor :   Are you there?
User :   hi
User :   yes
User :   she has also taken etoricoxib - -by ranbaxy yester
Doctor :   Is she having this problem in both the knees?
User :   no, only in right knee
User :   what are the medicines that u suggest
Doctor :   etoricoxib is an analgesic
Doctor :   she may continue the same
User :   ok
User :   so , right now we should consult an orhtopaedic and have the tests done...that ll identify which kind of arthritis this is ..rite?
User :   and go to physiotherapist as well?...can u suggest any exercises that she could do rite now?
Doctor :   Yes, if the orthopedician feels it is required, then he will prescribe it appropriately
Doctor :   7 days is a short time to go in for tests
Doctor :   but it depends on the physical examination
User :   ok..
User :   should we go to physiotherapist now, ? any exercises that you would suggest?
Doctor :   You may ask if physiotherapy is required during your next appointment with your orthopedician
User :   ok
Doctor :   Yes once the pain subsides, she must definitely start some exercises
User :   any other important thing that you would suggest v should do
User :   ok..which exercises?
Doctor :   Ask the Doc if she is fit for exercising
User :   ok
Doctor :   You can teach her knee strengthening exercises
Doctor :   which you can learn from the net
Doctor :   You Tube
Doctor :   Increase calcium in her diet
Doctor :   search for the list of foodstuffs rich in calcium
Doctor :   Losing weight will help a lot
User :   ok
Doctor :   Good shoes
Doctor :   with soft sole
Doctor :   will reduce impact on knee
Doctor :   Hi
Doctor :   Welcome back.
Doctor :   Are you there?
User :   hello
User :   yes
User :   :)
Doctor :   Did she suffer any strain or physical stress prior to the problem?
User :   maybe, she is not sure...
Doctor :   Ok, then only time will tell whether this is a short term or long term problem.
Doctor :   Hoping that it is short term, you follow my advise & also whatever your
Doctor :   orthopedician has told you.
User :   ok...
Doctor :   foodstuffs rich in calcium- Milk, cheese, yogurt, oranges and margarine
Doctor :   Milk, soy drinks, margarine, fish, liver and egg yolk are also the good sources of vitamin D
User :   ok.. :)
Doctor :   A few minutes of sun exposure daily or atleast on alternate days
Doctor :   These are just for prevention of bone related problems
User :   ok....u mean the knees should be exposed to sun....or just sun exposure in general?
Doctor :   General exposure, so that the skin gets to synthesis Vit D.
Doctor :   A few minutes only
User :   ok :)
User :   also doctore, there is a main concern...
Doctor :   Yes
User :   my mother is very fond of sight seeing, til now she was easily able to do a bit of trekking..and climbing small hills and stairs etc as compared to other people of her age
User :   can she continue doing that now that she has this problem?
Doctor :   Hopefully, she will be able to do so, in a matter of weeks.
Doctor :   That is, in case it was just an inflammatory arthritis
Doctor :   due to stress
Doctor :   But in case it is the osteoarthritis
Doctor :   then it is better to avoid such stresses
Doctor :   Your orthopedician will differentiate & identify it better
User :   ok
Doctor :   Hope you dont have any such event or expedition in mind
User :   in case it isosteoarthritis...then wat is the cure and medication to be taken ,,,,what is the duration of the course?
Doctor :   as she now absolutely needs REST
User :   yes, no travelling as of now
Doctor :   Osteoarthritis is a controllable degenerative disease of the joints
Doctor :   One can only control its progress, cant cure it.
Doctor :   Analgesics & steroids are used
Doctor :   Rest & physiotherapy/exercise as & when required
User :   hmmmm
Doctor :   The final thing that we do is joint replacement
User :   ok, what is that? how expensive? does it eradicate the problem completely?
Doctor :   The bone surfaces which are in contact are replaced
Doctor :   with metal coating
Doctor :   So we thereby create an artificial joint
Doctor :   costs between 50thousand to a lakh
Doctor :   It definitely improves the patients lifestyle
User :   ok :)
User :   it has any negative impacts?
Doctor :   Chances of failure of surgery in case the patient is in an advanced stage
User :   ok..
User :   also doctor, plz tell mother needs to take bed rest right now?
Doctor :   Rest the knee
Doctor :   no weight bearing on the knee
User :   today her pain was less because of the pain killers so she did the house work ....she should continue doing that....or take complete rest?
Doctor :   As long as her knee is rested(no body weight is transfered to it), it means her knee is resting
Doctor :   Her other parts of body need not rest
User :   she can go for a walk?
Doctor :   Not for few more days
Doctor :   she must slowly pick up knee exercises
Doctor :   Non weight bearing exercises for the knee
Doctor :   done sitting or lying
Doctor :   Slowly, with the consent of your orthopedician, she can be encouraged to walk
User :   ok
User :   so , climbing stairs is also not to be done ..right?
Doctor :   Climbing down is not to be done
Doctor :   Climbing up can be done, but only after a few weeks
Doctor :   Go up the stairs & come down the elevator
User :   ok
User :   i hope she doesnt have the permanent one
User :   right now she is taking pain killers only, till v meet up with the orhto paedic, he is going to meet us next week mostly,
User :   what are the medicines that u suggest? painkillers and otherwise
Doctor :   No other required
Doctor :   Vitamin supplement may be taken for sometime, no proof of how much it helps
Doctor :   Same with calcium supplement
Doctor :   Better way is to just increase them in the diet.
Doctor :   Fresh fruits & vegetables have all the vitamins
User :   ok...
User :   so she should continue with etoricoxib?
Doctor :   Yes, as long as your doc thinks it is required
User :   is this medicine very strong?...are there any others more preferrable that she should take?
Doctor :   The best for now.
Doctor :   Every drug has its own list of side effects
Doctor :   it has minimal side effects compared to other drugs in its group
User :   ok..
User :   thats good to know
User :   thankyou have been a great help :)
User :   is there any other important thin that i need to take care of ?
User :   in general regarding mother
Doctor :   Make sure she gets the exercise she needs, daily. If required, put her in a gym. Thyis to be done later.
Doctor :   Is there any thing else I can help you with?
Doctor :   In general a 54year old woman needs screening tests for Breast & Cervical cancer. Contact a gynecologist.
User :   ok
User :   also doctor there is another different concern that i wanted to ask
Doctor :   Yes
User :   my wife had an abortion last week via MTOP
User :   her bleeding has stopped now, but during the process, when the bleeding was present, we had intercourse
Doctor :   Ok
User :   our gynaecologist didnt tell us any precaution in this regard, but now i have come toknow that there might be chances of infection
User :   can you elaborate in this regard?
Doctor :   Chances of injured external genitalia, which is prone to get infected via your external genitalia
Doctor :   during the act
Doctor :   also exaggerates the existing injury
User :   so my wife has chances of getting infection? is there a chance for me to get infection?
Doctor :   yes even you also have the chance of getting infection
User :   so how do we determine if we are infected? whom to consult? which tests to take? any medicines or precautionary course that we can take right now to prevent infection?
Doctor :   if you have any symptoms like burning sensation while passing urine, ulcer or wound on the external genetilia, pus discharge from urethra than only you need to look into investigating for infection
Doctor :   if at all you develop such symptoms than you need to consult a urologist
Doctor :   there is no use of taking any medicine now. because the medicines can only work and give result when there is disease
Doctor :   for now you need to wait an watch for the symptoms as mentioned, if no symptoms develop than you dont need any investigation and or treatment
User :   ok, in how many days/weeks the symptoms shall surface? or after how many weeks can we be assured that no infection is going to settle?
Doctor :   usually with in 2 weeks
User :   ok, and we can be reassured if two weeks pass without any symptoms?
Doctor :   usually yes
User :   ok
User :   if we get infected, it can cured prperly and fastly rite?
Doctor :   yes it can be cured completely
User :   ok, any precautions that we sould take now? any thing that my wife should follow as precaution, she is more prone for infection here , right?
Doctor :   apart from keeping personal hygeine nothing much precautionary measures. can consume lot of water so that more urine is passed and the infection is flushed out
User :   ok
User :   thankyou doctor for your help and patience :)
Doctor :   Thanks for consulting me. Bye for now. Please refer your friends to our service.
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