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Diagnosed with CIDP and fibromyalgia. Noticed spots behind knee cap. Could it be cancer?

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General & Family Physician
Practicing since : 2009
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I have been diagnosed with CIDP and Fibromyalgia. A yr and a half ago I had a total throyidectomy due to cancer. I have been having numerous problems with swelling (like at least 4-5" greater around) and then my legs swell along with my ankles and feet. I can barely walk up and down stairs, and it continues to worsen. I cant stand, walk or sit for hardly any amount of neurologist said the IVg treatments for CIPD are very expensive so he does not want to do them! All he has done is put me on steroids (prednisone, only result is weight gain) so now, and in extreme depression over being in pain 24/7 but the weight gain, I cant stand..I am very insecure of my weight, so the depression continues to get worse, even on an anti depressant. So, my doctor finally at least did xrays of my knees..when they were 19 1/2' around!!! thats how swollen they the xray tec was sweet and let me look at the xrays. Both knees, showed a white spot directly behind the knee cap. I asked what it was and he said just bone, it happend all the time..I HAVE NEVER SEEN THEM, and I have worked in the medical field for over 20 yrs. SO I just seem to have one thing after another...the firbromyalgia, has me in constant pain throughtout my body along with all they other 'wonderful' symptoms of it, and the horrible knee pain from the CIDP, I cant even bend my knee completely, or squat to pick something up. I cant take a hot bath, because I cant bend my knees to get in or out. I am only 45 yrs old! None of this runs in my family. My disability denied, so we appealed, and my lawyer continues to add new diagnosis, tests, etc. I read about an injection called Synvisc, and will be asking my neurologist about it. He isnt very proative about anything, I am getting extremely discouraged with all of this. So, first off..the spots behind my knees, I worry so much about cancer..I am high risk for lymph node cancer per my surgeon for my can it be cancer? My neurologist suggested an nerve and/or bone biopsy, is that necessary? What about the Synvisc, and the IVg treatments...and something to help with weight gain , i really cant exercise..and I am on adderall for energy and wt suppressant. So what is the best course, and could the spots be cancer????

I meant to add my medication.. synthroid 200mcg, cytomel 25 mg, albuter and symbacort when needed ( i get pneumomia easy since this started)Adderal, 30mg 2x a day, Lorazepan 2 mg 2 at bedtime and as needed (he wants me off of this, but if i dont take it I CANT SLEEP AT ALL!) My old dr had me on 15mg of morphine as a break thru med, but my neurologist will not prescribe it altho I told hem it worked great. b complex 1x day, calcium 600, 3xday, hydrochlorothiazide 12.5 mg 1/2 to 1 daily for edema, oxycodone XXXXXXX every 4-6 hrs for pain, flexeral 10 mg, 3xday as needed, calcitroil 0.25 mg 2daily, flonase 2 sprays in each side dialy, 5HTP, Thyroid and cortisol energy (supplements) Fentanyl, 100mcg, 1 every 72 hrs, and the newest, Tizanidine for spasms, 4mg 1/2 at bedtime. I had been getting oxys 15 mg, to take during the day or if a 30 wasnt enough..but he will not prescribe both. I was on valium, wich worked WONDERUL! he took me off that because of the ativan...I cant seem to tolorate the patches, I break out something terrible and alot of time will not stay on. I am getting to the point where the oxy 30s arent working as well, i have been on them quite wahile, but he doesnt want to add anything or up the dosage..and i know after sometime, you do have to increase the meds I would think he would know this...

I just had labs done last week, checking my estrogen (possible menopause, I also had a hysterectomy in 2007 but have one ovary left. the last set of labs done were May 2012 vit D 25 hydroxy (broke down OH D3,D2 59, 24, 35
T3 free 3.6 glucose 75, bun, 7, creatinine 0.7 bun/creatT PROTEIN 6.7, ALBUMIN 3.2, GLOBULIN 3,5, A/G RATIO 0.9, calcium 8.5, sodium 135, pottasium 3.3 chloride 101 co2 28,8 anion gap 8 CBC/DIFF
WBC 7.3
RBC 4.47
HCT 44.3
MVC 99.0
MCH 34.5
HPV 8.2
2 WEEKS LATER, WBC 13.1, RBC 4.43 RDW 9.2


FREE T4 1,87
TSH <0.01

I had xrays on 12/2011 on knees and feet:

In rt knee there are small osteophytes at the edge of the medial and lateral compartment. A joint effusion is present. no joint space narrowing. Early changes of osteoarthritis in both knees, small knee joint effusion

My EMG recently,,evidence or peripheral polyneuropathy affecting lower extremities, appears distal, symmetrical polyneuropathy with mild degree of axonal and myelin changes. rt upper extremity findings were normal.
My lumbar spine:
mild scoliosis convex to the rt. osteophytes are present at several discs without disc space narrowing. Some minor degenerative changes in a few lower lumbar facet joints
no evidence of XXXXXXX vein thrombosis. Slightly enlarged lymph node is incidentally noted in the rt upper groin.
CT w/contrast Chest
Tiny left lower lobe nodule seen 'most likely' benign
A small calcified granuloma appeared on the left upper lobe
Very tiny pleural based nodule in the rt lower lobe appears to be benign as well,

I have many more, but i think this shoud do..thank you
Posted Tue, 23 Oct 2012 in Cancer
Answered by Dr. Aparna Kohli 20 hours later
Thanks for writing to us.
I would be addressing your concerns in 2 parts. First, I'll take your direct questions. Then we'll try and make sense of the whole picture.
It is extremely unlikely that the spots in your Xray is cancer. This is because the there are only 6-7 lymph nodes in the popliteal fossa ( the space behind your knees) and I would not expect your thyroid cancer to spread to them. Even if it did, I would not expect to see them on a Xray. Thyroid cancer, of which the papillary cancer is the most common type, ha a remarkably good prognosis after resection. Even if does spread, which it does rarely, to the neck lymph nodes and lung, followed by the bone, brain, liver, and other sites.
Given the constant pain that you are in, a nerve biopsy may be prudent.
I do not think Synvisc is such a great idea at your age. We should be trying other treatment options first.
The best course would be to treat the pain ( and morphine is not the best option, because it can get you hooked and we would need to keep increasing the dose).
We also need to start you on some kind of physiotherapy so that the pain can be dealt with.
Please do remember that the depression, weight gain, osteoarthritis ( which is only made worse by weight gain) is becoming 1 vicious cycle. You will need to deal with depression by talking to people, getting along with friends and family and probably seeking therapy.
Also, it would be a great idea to try yoga and pranayama which have been known to help with pain. These techniques have been known to help with pain.
Let me know if I can address any more concerns
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