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Suggest treatment for persistent severe pain and lumps behind right knee

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Posted on Thu, 21 May 2015
Question: I've had severe pain in the back of my right leg for over a week. It was accompanied by a bunch of soft lumps mainly behind my knee, but were up and down the leg. The pain started in my ankle and foot, but settled in the back of my thigh. A few days into the pain, my right arm started hurting as well, it felt like Arthritis and muscle spasams mixed, but also similar to the leg pain. The arm hurt so badly that I was massaging it and found a lump which was soft and spongy. The pain overall has felt like severe painful muscle spasams, along with sharp stabbing pains and almost felt like the blood flow was constricted at times. I am 47 years old, a smoker with hyperthyroidism, hypertention, arthritis and impingement syndrome.
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Answered by Dr. Suresh Heijebu (31 minutes later)
Brief Answer:
Possible exacerbation of rheumatoid arthritis.

Detailed Answer:
Hi Madam.

I understand your concern.

You possibly seem to have a flare up of arthritis most like rheumatoid arthritis/RA.

It can present with subcutaneous nodules known as rheumatoid nodules.

I advise you to have the following tests.

Erythrocyte sedimentation rate
C-reactive protein level
Complete blood count
Rheumatoid factor assay
Anti nuclear antibody assay
Anti−CCP/cyclic citrullinated peptide assays.

These test detect the severity of arthritis and pave way for new treatment modalities.

Also an x ray both knees in AP and Lateral view is advocated to document the presence of these nodules.

Hyperthyroidism and hypertension will not cause such symptoms.

Meanwhile in order to control pain you need to take tab diclofenac 50 mg every 8th hourly.

The definitive management consists of taking Methotrexate and sulphasalizine in documented cases of RA..

Please note these drugs have to be taken only under strict medical prescription.

Post your further queries if any.
Thank you.


Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Suresh Heijebu

General & Family Physician

Practicing since :2010

Answered : 3664 Questions

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Suggest treatment for persistent severe pain and lumps behind right knee

Brief Answer: Possible exacerbation of rheumatoid arthritis. Detailed Answer: Hi Madam. I understand your concern. You possibly seem to have a flare up of arthritis most like rheumatoid arthritis/RA. It can present with subcutaneous nodules known as rheumatoid nodules. I advise you to have the following tests. Erythrocyte sedimentation rate C-reactive protein level Complete blood count Rheumatoid factor assay Anti nuclear antibody assay Anti−CCP/cyclic citrullinated peptide assays. These test detect the severity of arthritis and pave way for new treatment modalities. Also an x ray both knees in AP and Lateral view is advocated to document the presence of these nodules. Hyperthyroidism and hypertension will not cause such symptoms. Meanwhile in order to control pain you need to take tab diclofenac 50 mg every 8th hourly. The definitive management consists of taking Methotrexate and sulphasalizine in documented cases of RA.. Please note these drugs have to be taken only under strict medical prescription. Post your further queries if any. Thank you.