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Suggest remedy for persistent inflammation and pain in knee

Answered by
Dr.
Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 12021 Questions

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Posted on Fri, 23 Oct 2015 in General Health
Question: I am a 53 year old nurse who is having problems with my right knee. It has been off and on issues for years which have lead to a nasty fall and epistaxis. The knee feels like it catches and causes severe pain to bear any weight. I never know when it will occur and it is occurring more frequently for longer periods of time. I am unable to bear weight due to the pain when it occurs. It always feels tight like there is swelling in the knee joint but does not look swelling. I had a recent MRI results read s follows
EXAM: MRI EXAMINATION OF THE RIGHT KNEE
CLINICAL INFORMATION: Right knee pain and swelling. Catching and locking. Chronic, recurrent and worsening symptoms.
TECHNICAL INFORMATION: Multiple proton density images were obtained in the axial, sagittal and coronal planes, followed by proton density fat suppression images in the axial and sagittal planes. Coronal T2 fat suppression images were also obtained. There are no prior studies available for comparison.
INTERPRETATION:
Bones: Localized mild subchondral cystic change at the patella. There is no evidence of acute fracture. No other abnormal bone marrow edema pattern is identified.
Ligaments and tendons: The medial collateral ligament is intact, without acute sprain or tear. The iliotibial band, fibular collateral ligament, biceps femoris tendon and popliteus tendon all are intact. The anterior cruciate ligament is intact without acute sprain or tear. The posterior cruciate ligament is intact.
Extensor Mechanism: The patellar and quadriceps tendons are intact. The medial and lateral retinacula are intact.
Knee Joint: There is a small knee joint effusion. No discrete popliteal cyst. Synovitis, without a focal loose body.

I have a long standing history of AS and am on biologics and cannot take antiinflammatories anymore I recked my stomachs from years of use. I am unable to do steroid injections due to being hospitalized twice with angina from my microvascular heart disease after a clerical injection and a foot injection. I was told to go to PT but if I can't bear weight what are they going to do. I had recent tarsal tunnel surgery and gastric muscle release on the right foot and calf in January of this year. Should I get a second opinion?
doctor
Answered by Dr. Praveen Tayal 1 hour later
Brief Answer:
Non weight bearing exercises can help.

Detailed Answer:
Hello,
Thanks for posting your query.
As per MRI report, you have mild inflammatory changes in the knee joint. It can be relieved to some extent with hot compress, TENS therapy and physiotherapy exercises. Local analgesic gels can also help you for a short term. Even if you are not able to bear any weight on the joint non weight bearing exercises can help in regaining the muscle strength to some extent. It will help in decreasing the pain. The weight bearing can then be started gradually.
You can take a second opinion also but there are not many choices for you.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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