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Sprained wrist and knee. Having swelling. X-ray clear. Suggestions

On March 12th, I slipped on the ice at work. I fell mostly on my right side, or so I thought. I sprained my wrist and was on restrictions until March 19th. On March 14th, I noticed my left knee looked "deformed". It is hard to describe, especially in writing what it looks like. When I first noticed it, there was no pain. But the longer I was on my feet, the more it hurt. I left work early on the 14th and went to urgent care to get evaluated. She told me it was bursitis and to keep it wrapped for 3 days and if no relief of symptoms to follow back up. Sunday, March 17th I noticed it was getting to the point to where it took me awhile to be able to bend my knee. And if I got into a kneeling/crouching position with my knees off the floor, it took awhile to get back up. Monday, March 18th I went to the Emergency room to be evaluated again. He told me I had a lot of swelling inside my joint cavity of the knee and he was diagnosing me with a knee sprain. He placed me in a knee immobilizer for a few days until I met with the Occupational Health evaluators. They are puzzled as to what the issue is on. These people didn't mention anything about bursitis. But last night, March 22nd, I noticed the swelling has moved down past my knee cap and half way through my leg. It is only on the outside part of my left leg.

I am no stranger to knee issues, but I have never had anything like this happen. We are approaching two weeks since my fall and there truly hasn't been any relief with everything I have done. Occupational Health is referring me to an orthopedic surgeon soon. But until that appointment, is there ANY suggestions to help give me a bit more relief? The xrays showed no chips/fractures/dislocations.
Asked On : Tue, 26 Mar 2013
Answers:  2 Views:  26
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Radiologist 's  Response
May 2014
Thanks for writing in.

With your description of problems, the possibility of ligamentous and meniscal injury in your knee is more likely. In most of the milder situations, the X ray appears normal or with a slight soft tissue swelling. The patient develops problems subsequently in days to come especially after a period of mobilization, when they start normal physical activities.

You surely need to be seen by an orthopedic surgeon. He may ask for a MRI scan of knee joint and confirm any tears in ligaments and menisci. Further treatment will depend on the imaging findings.

Hope this helps.
Answered: Sun, 21 Jul 2013
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Orthopaedic Surgeon, Joint Replacement Dr. K. Naga Ravi Prasad's  Response
Jul 2013
Hi, thanks for writing to HCM.

After going through the description, I feel that it could be EFFUSION in the knee secondary to the injury sustained. This generally indicates some form of insult/injury to the intra articular structures (soft tissues in the joint).

This cannot be bursitis since bursae are present outiside the knee joint and will produce swelling confined to that area where bursa is present (in your case, the swelling of the knee is diffuse).

I suggest you to have a MRI scan of the knee joint to diagnose any damage to the intra articular structures like ligaments, meniscus, capsule etc.

Consult an orthopedic surgeon and follow his advice accordingly. Good day
Answered: Sun, 21 Jul 2013
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