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What Causes Severe Knee Pain Despite A Normal X-ray Report?

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Posted on Wed, 12 Oct 2016
Question: I have fairly severe pain that arose suddenly Thursday night, couldn't bear any weight in right knee at all. No injury, no over-use at all prior to this. I'm 45 yr old female, good muscle tone, I work out regularly. I had a heavy head cold prior that was showing signs of improvement by that time. Some swelling mostly just above the knee. Went to urgent care on Friday morning, they x-rayed, nothing broken. Possibly some fluid around knee. Some improvement Sunday and Monday. Generally no pain while at rest. Able to bear some weight on Monday. Have continued periodic icing. Now extremely sore knee again overnight, can't bear any weight this morning. This time I suppose it is related to Monday's limited walking with walker & crutches. Not much swelling this morning, just pain even while at rest. We were somewhat convinced that lymph nodes above right knee were fighting the cold, which I understand is unusual but possible. Now I'm not so sure. Any thoughts? Must I continue to wait it out?
Found the xray report: "The bones appear intact without evidence of fracture or acute osseous abnormalities. Joint spaces appear maintained without significant degeneration. there appears to be some fluid present in the suprapatellar recess."
Then doctor's mpression: Probable joint effusion.
Suggested possible causes:
Synovial effusion. ok, seems likely. Limited range of motion, bend to about 100 degrees, straighten to about 170 degrees.
Hemarthrosis, Bursitis, - but no injury, pain is above knee. Only mild tenderness to touch most of the time.
Possible Ortho referral.
doctor
Answered by Dr. Dr. Naveen Kumar Sharma (2 hours later)
Brief Answer:
I think you have acute knee synovitis

Detailed Answer:
Hello,
Have studied your case and I think you are having knee synovitis. In this condition there is sudden onset of severe pain in knee joint in a pre existing arthritis. This can be triggered by walking, knee bending or some time there is no obvious causes. I have few suggestions for you.
1.Ice application is good.
2.You need to visit a orthopaedic surgeon and get steroid and synvisc injection in knee joint.This will give you immediate pain relief and it will last more then three months to nine months.
3.Avodi squatting, sitting cross leg and stairs. Also you can take physiotherapy.
4.In cases when you have multiple episodes then get MRI of the knee joint as there can be loose body or meniscus tear inside. It will improve with arthroscopic debridement.
I hope these steps will be helpful for you.Let me know if there is any other followup questions.
thanks
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
doctor
Answered by
Dr.
Dr. Dr. Naveen Kumar Sharma

Orthopaedic Surgeon, Joint Replacement

Practicing since :2002

Answered : 4486 Questions

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What Causes Severe Knee Pain Despite A Normal X-ray Report?

Brief Answer: I think you have acute knee synovitis Detailed Answer: Hello, Have studied your case and I think you are having knee synovitis. In this condition there is sudden onset of severe pain in knee joint in a pre existing arthritis. This can be triggered by walking, knee bending or some time there is no obvious causes. I have few suggestions for you. 1.Ice application is good. 2.You need to visit a orthopaedic surgeon and get steroid and synvisc injection in knee joint.This will give you immediate pain relief and it will last more then three months to nine months. 3.Avodi squatting, sitting cross leg and stairs. Also you can take physiotherapy. 4.In cases when you have multiple episodes then get MRI of the knee joint as there can be loose body or meniscus tear inside. It will improve with arthroscopic debridement. I hope these steps will be helpful for you.Let me know if there is any other followup questions. thanks