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Stiff And Painful Knee, Chest-xray Showed Arthritis Of Spine Between Shoulder Blades. Do I Have Arthritis In My Knees?
Question: Good afternoon Doctor,
First and foremost I don’t consider myself a very active guy. I do play volleyball twice a week for about 2 hours each time. I’m 6 feet tall and I weight at 160 bounds which I consider healthy. I’m not one of those guys that work out 5 times a week but I’m still somewhat active but nothing crazy.
About 2 years ago May 2010 at the age of 25 I went hiking with friends for the first time and the trail was somewhat rough, a lot of climbing, bending, and jumping.
About a month after this event I developed stiff and painful knee on the outside part of both knees “Mostly the side”, BUT GET THIS, it was NEVER both knees at the same time. It would be the right knee for about 2-4 days then the pain would go away then it would be the left knee with the same time interval. Those weird episodes lasted for about a year.
The onset of the pain would be worst during the morning after I wake up and it would last for several hours then it would go away.
All of the sudden the pain went away after a year or so. Fast forward to XXXXXXX 2012. The same pain started again, worst in the morning, goes away after few hours and this time it’s the left knee only. This would be day 2 of this symptom. As you can see I’m really confused.
The reason why I mentioned that story is because of this, I went for a chest x-ray in May 2012 and I was told I have mild arthritis of the spine between my shoulder blades. I took the news hard but I’m in the process of getting a second opinion. What doesn’t add up to me is that I have ZERO back problems so I’m a bit confused with that diagnosis as I have no pain. The only time I do experience a sore upper back is if I’m standing up for a long period of time.
I can’t help but think now I have had arthritis on my knees for 2 years without knowing but the symptoms don’t add up except for the morning stiffness from what I read online.
Your feedback is greatly appreciated.
XXXXXXX
First and foremost I don’t consider myself a very active guy. I do play volleyball twice a week for about 2 hours each time. I’m 6 feet tall and I weight at 160 bounds which I consider healthy. I’m not one of those guys that work out 5 times a week but I’m still somewhat active but nothing crazy.
About 2 years ago May 2010 at the age of 25 I went hiking with friends for the first time and the trail was somewhat rough, a lot of climbing, bending, and jumping.
About a month after this event I developed stiff and painful knee on the outside part of both knees “Mostly the side”, BUT GET THIS, it was NEVER both knees at the same time. It would be the right knee for about 2-4 days then the pain would go away then it would be the left knee with the same time interval. Those weird episodes lasted for about a year.
The onset of the pain would be worst during the morning after I wake up and it would last for several hours then it would go away.
All of the sudden the pain went away after a year or so. Fast forward to XXXXXXX 2012. The same pain started again, worst in the morning, goes away after few hours and this time it’s the left knee only. This would be day 2 of this symptom. As you can see I’m really confused.
The reason why I mentioned that story is because of this, I went for a chest x-ray in May 2012 and I was told I have mild arthritis of the spine between my shoulder blades. I took the news hard but I’m in the process of getting a second opinion. What doesn’t add up to me is that I have ZERO back problems so I’m a bit confused with that diagnosis as I have no pain. The only time I do experience a sore upper back is if I’m standing up for a long period of time.
I can’t help but think now I have had arthritis on my knees for 2 years without knowing but the symptoms don’t add up except for the morning stiffness from what I read online.
Your feedback is greatly appreciated.
XXXXXXX
Hello XXXXXXX,
Thanks for writing in.
I am a medical specialist with an additional degree in cardiology.
Your concern is genuine and I read your detailed description with diligence.
If we go into details of your history what you have
Arthritis (if there were swelling of one of both knees) or Arthralgia (if there was no swelling in pain. Unmasked by injury and abrupt movement of the other joint occurring two years ago. Second thing you have is radio-logical changes in spine x-ray but no symptoms. Usually, x-ray changes follow the symptoms not other way round. What about other investigations like RF factor or HLA B 27 ? Per se you do not fit into sero+ve poly arthritis or sero negative poly arthritis. Technically, you have to have arthritis (pain, limitation of movement and swelling- at least 2 out of 3) in 4 or more joints to call yourself suffering from poly arthritis. So, far you have not told anything about that. You have two opinions from doctors who had opportunity to examine you what do they say. Let us have answers to all these questions before jumping to any serious conclusion. Lastly, think carefully, and tell whether you have noticed any skin abnormality, abnormal sensations while passing stool or urine or problem with your eyes. These are also relevant question if the answer is no. We are dealing with much less serious situation here. Good reason for concern but not of panic.
Looking forward to hear from you in followup query so that we discuss further and plan a treatment schedule.
With Best Wishes
Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M. Cardiology)
http://www/ WWW.WWWW.WW
Thanks for writing in.
I am a medical specialist with an additional degree in cardiology.
Your concern is genuine and I read your detailed description with diligence.
If we go into details of your history what you have
Arthritis (if there were swelling of one of both knees) or Arthralgia (if there was no swelling in pain. Unmasked by injury and abrupt movement of the other joint occurring two years ago. Second thing you have is radio-logical changes in spine x-ray but no symptoms. Usually, x-ray changes follow the symptoms not other way round. What about other investigations like RF factor or HLA B 27 ? Per se you do not fit into sero+ve poly arthritis or sero negative poly arthritis. Technically, you have to have arthritis (pain, limitation of movement and swelling- at least 2 out of 3) in 4 or more joints to call yourself suffering from poly arthritis. So, far you have not told anything about that. You have two opinions from doctors who had opportunity to examine you what do they say. Let us have answers to all these questions before jumping to any serious conclusion. Lastly, think carefully, and tell whether you have noticed any skin abnormality, abnormal sensations while passing stool or urine or problem with your eyes. These are also relevant question if the answer is no. We are dealing with much less serious situation here. Good reason for concern but not of panic.
Looking forward to hear from you in followup query so that we discuss further and plan a treatment schedule.
With Best Wishes
Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M. Cardiology)
http://www/ WWW.WWWW.WW
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Evening Doctor XXXXXXX
I apologize I'm having somewhat of a difficulty understanding the terms you are using but I will do my best to answer them.
I will start with the knee issue. As I explained above the only restricted movements I had was mostly in the morning. It made going up and down the stairs somewhat difficult and I walked a bit funny, but it wasn't great pain. I would say it was on an average scale. As time went by 1-3 hours I was feeling ok and it was never both knees at once. My family doctor at the time sent me to a Physiotherapist doctor if I'm using the right term. The doctor looked at my knee and said she believes something is torn but I never had an injury before. I was a bit confused because how can you diagnose something like that without a more invasive examination, am I correct?
I'm going Tuesday to the doctor to get a referral for an x-ray to rule out arthritis of the knee. Would you recommend another test? like MRI for example? or a blood test perhaps?
As for my spine arthritis, I wasn't really going for back pain. I'm a casual smoker and I usually get a chest x-ray once a year to check up on my lungs until I got a call from my doctor telling me I have Mild Arthritis of the Spine. She said it was only one bone and she said she would mail me some exercises to my house. The lack of information I got from her put me on edge, thats why I want a second opinion. My understanding arthritis hurts and I'm feeling fine except for the occaional sore back which everyone gets. To my knowledge you can't start a treatment unless you know what type of arthritis you have. So I was thinking when I see her Tuesday I will ask for a referral for an arthritis specialist. Do you recommend that?
Lastly I have noticed no swelling, my vision is perfect, bladder is ok, passing stool never a problem, nothing weird of any sort.
Thank you again,
XXXXXXX
I apologize I'm having somewhat of a difficulty understanding the terms you are using but I will do my best to answer them.
I will start with the knee issue. As I explained above the only restricted movements I had was mostly in the morning. It made going up and down the stairs somewhat difficult and I walked a bit funny, but it wasn't great pain. I would say it was on an average scale. As time went by 1-3 hours I was feeling ok and it was never both knees at once. My family doctor at the time sent me to a Physiotherapist doctor if I'm using the right term. The doctor looked at my knee and said she believes something is torn but I never had an injury before. I was a bit confused because how can you diagnose something like that without a more invasive examination, am I correct?
I'm going Tuesday to the doctor to get a referral for an x-ray to rule out arthritis of the knee. Would you recommend another test? like MRI for example? or a blood test perhaps?
As for my spine arthritis, I wasn't really going for back pain. I'm a casual smoker and I usually get a chest x-ray once a year to check up on my lungs until I got a call from my doctor telling me I have Mild Arthritis of the Spine. She said it was only one bone and she said she would mail me some exercises to my house. The lack of information I got from her put me on edge, thats why I want a second opinion. My understanding arthritis hurts and I'm feeling fine except for the occaional sore back which everyone gets. To my knowledge you can't start a treatment unless you know what type of arthritis you have. So I was thinking when I see her Tuesday I will ask for a referral for an arthritis specialist. Do you recommend that?
Lastly I have noticed no swelling, my vision is perfect, bladder is ok, passing stool never a problem, nothing weird of any sort.
Thank you again,
XXXXXXX
Hi XXXXXXX,
Thanks for a prompt response.
Apologies are all mine and I should have been more careful but I had thought you had been through tests for arthritis so terms I mistakenly used would be familiar to you. As now we establish that it is not physical involvement of more than one or two joints (we are discounting spine as incidental x-ray finding and hope that you will never develop symptoms justifying further investigations on that count). Moreover, involvement of spine is never one joint affair it is always multiple joints so label of arthritis is wrong by seeing one joint on x-ray( as described by you).
I entirely agree with you knee joint is most complex joint involve 3 bones and 19 ligaments it needs more respect than a cursory referral for physiotherapy. You are perfectly justified in getting investigation(s) done. If the doctor has now examined it and all he has agreed to refer for x-ray, I would recommend that you ask him to order MRI also for it does not involve any radiation exposure. It gives much more information about soft tissue, joint fluid and ligaments we just referred to. And for a volley ball player or a young man of 27, it is most important joint. If there is something positive in x-ray or MRT; then yes doctor himself/herself will order battery of tests. Write to me after the test we can take it from there, For some issues have been left un-discussed for we do not have a first proper diagnosis as yet. And, please mention all the terms I used in my first reply which were not clear: I promise to clarify to your satisfaction, otherwise I am failing in my communication skill, which I can never forgive myself for.
Best Wishes
Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M. Cardiology)
http://www/ WWW.WWWW.WW
Thanks for a prompt response.
Apologies are all mine and I should have been more careful but I had thought you had been through tests for arthritis so terms I mistakenly used would be familiar to you. As now we establish that it is not physical involvement of more than one or two joints (we are discounting spine as incidental x-ray finding and hope that you will never develop symptoms justifying further investigations on that count). Moreover, involvement of spine is never one joint affair it is always multiple joints so label of arthritis is wrong by seeing one joint on x-ray( as described by you).
I entirely agree with you knee joint is most complex joint involve 3 bones and 19 ligaments it needs more respect than a cursory referral for physiotherapy. You are perfectly justified in getting investigation(s) done. If the doctor has now examined it and all he has agreed to refer for x-ray, I would recommend that you ask him to order MRI also for it does not involve any radiation exposure. It gives much more information about soft tissue, joint fluid and ligaments we just referred to. And for a volley ball player or a young man of 27, it is most important joint. If there is something positive in x-ray or MRT; then yes doctor himself/herself will order battery of tests. Write to me after the test we can take it from there, For some issues have been left un-discussed for we do not have a first proper diagnosis as yet. And, please mention all the terms I used in my first reply which were not clear: I promise to clarify to your satisfaction, otherwise I am failing in my communication skill, which I can never forgive myself for.
Best Wishes
Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M. Cardiology)
http://www/ WWW.WWWW.WW
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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