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What Causes Stabbing Pain In Knees When ESR Level In Blood Is 55mm/h?

Posted on Fri, 19 Feb 2016

Question: i am a 29 year old female. i have joint pains since last three years. The MRI revealed bilateral cysts in femoral heads and neck. Apart from this, i have severe stabbing pain in my knees sometimes. The XXXXXXX i can walk is around 500-600m and start limping after that. My RA factor is negative, anti CCP is negative, HLA B27 is negative but the pain does not subside. my ESR is 55. What can be the possible reason

Answered by Dr. Aashish Raghu (54 minutes later)

Brief Answer:
Inflammatory arthritis, Pes anserine bursitis. Needs further workup

Detailed Answer:
Hi there.

Thanks for the query.

Do you have pain while squatting?

Any feeling of instability of the knee in walking uphill or downhill?

Any hip or groin pain?

Cysts in the femoral head and neck could indicate avascular necrosis but further evaluation like clinical examinable and am MRI may be required to rule out other conditions.

Knee pain after walking long distances could be Pes anserine bursitis, Patellar tendinitis, meniscal cartilage tear etc. ESR being 55 inductees an inflammatory disorder love Seronegative arthritis as well such can possibly be Lyme arthritis, Gonnococcal arthritis, Reiter disease etc.

Kindly avoid strenuous activity and long walks. Apply hot packs to the painful regions and keep the long elevated over pillow. Avoid extreme flexing or extending the knee. Take pain killer like Tablet Ibuprofen 400mg twice a day for 5 days after meals. You could get an MRI scan of the knee if this fails to improve you in a couple of weeks.

I hope I have answered your query.

I will be available to answer your follow up queries.

Regards,

Dr. Aashish Raghu

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Aashish Raghu (32 hours later)

Hi Doctor

Thank you so much for your answer.
AVN is ruled out as MRI does not show any signs of it. All tests of arthiritis are also negative. I've undergone a bone scan also and it failed to detect anything. I am taking Gabapantin and Etova 600 along with NTP on doctors advice but the affect of painkillers do not last long. It is just a temporary relief for 2-3 hours.

I would also like to tell you that there is mild dull tolerable pain in both the hips as well as left knee but occasionally i feel sudden sharp episodes of pain which are intolerable. I become incapacitated at those times.

I was suggested FNAC but that couldnt be carried out as the cysts are deep inside the bone. I have bursitis in left hip on the outer side but that does not explain the groin pain.

Please suggest

Answered by Dr. Aashish Raghu (25 hours later)

Brief Answer:
Could be labral tear, meniscus tear. Needs Sports Medicine Specialist consultation

Detailed Answer:
Hi there.

Thanks for the reply.

Bursitis of the hip can cause groin pain very frequently.

Cysts in the head and neck of the femur can be incidental and attributed even to degenerative changes like arthritis. Labial tears need to be ruled out especially if you have sharp pains.

I advise you to not strain the joints. Apply ice or hot packs, whichever works for you. If you have clicking sensation and sharp pains in the hip, you could get a consult by a Sports Medicine Specialist to rule out labial tears which can be repaired. The joint can be explored using key hole surgery technique with camera scopes.

Regarding the knee, sometimes hip pain can be referred to the knee. If you feel pain inside the knee on flexing it, climbing stairs or squatting, it could indicate meniscus tear and needs an MRI to detect.

I hope I have answered your query.

Regards,

Dr. Aashish Raghu

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Sonia Raina