Suggest treatment for swelling and pain in knee post an accident

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Posted on Thu, 28 Jan 2016 in Bones, Muscles and Joints
Question: I twisted my left knee and fell on it aprximately 4 days ago. The swelling has continued to,worsen, medial and lateral pain, and I now have swelling on the top medial part of my calf which is very painful.

Rest, ice and elevation have not helped. Compression increases the pain levels.

Any suggestions at this point?
doctor
Answered by Dr. Vivek Chail 1 hour later
Brief Answer:
It is probable that there is ligament or meniscal injury with effusion

Detailed Answer:
Hi xxxxxxxxxxxxxxx,
Thanks for writing in to us.

I have read through your query in detail.
Please find my observations below.

1. Twisting of the knee can cause injury to structures which keep the knee joint in place, like ligaments and menisci.

2. A trivial injury should have started healing by itself in 4 days and if the pain is worsening then it is a concern and can mean that there is significant injury which can involve a subtle fracture. The swelling can result from fluid accumulation due to knee joint effusion.

3. In the above situation, if there is no relief with NSAIDS, ice, compression, rest, limb elevation then you should consult the orthopedic surgeon. If you do not get an early appointment due to long weekend then please go to the ER. They will do a x ray and if required then an ultrasound and MRI knee joint. Ligament and meniscal tears cannot be known without doing a MRI scan and this is probably the reason for your continuing pain and discomfort.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vivek Chail 2 days later
I did go to ER for my swollen and painful knee. The swelling was starting to go into the top medial calf, so an ultrasound was done to rule out a DVT. X-Rays were negative and ultrasound was negative.

Ace wrap causes increased pain. Any pressure on the back of the knee or medically causes sharp pain. Is this indicative of a medial lateral tear or meniscus tear?
doctor
Answered by Dr. Vivek Chail 3 hours later
Brief Answer:
The medial collateral ligament and medial meniscus can have injury

Detailed Answer:
Hi xxxxxxxxxxxxxxxxxxx,
Thanks for writing back with an update.

1. If x ray and ultrasound are normal then there is no bone injury or any joint effusion in the affected knee.

2. There is a probability of medial collateral ligament and medial meniscus injury if the pain in on the inner side. Some times the anterior collateral ligament can have a partial tear.

3. The meniscus injury is likely if you are having pain which increases on lifting yourself up from a sitting position and when squatting. In most situations a small tear will heal in 2 weeks time. Please reduce the use of your hurting knee and avoid actions which will cause stress on it. Depending on your symptoms, you doctor might recommend a knee MRI scan

Hope your query is answered.
Please do write back if you have any doubts.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6699 Questions

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