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Old 05-31-2012, 02:48 PM   #1
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Unhappy Major Knee Pain... Help!

Hi! i am a 25 year old female with major knee pain. Apparently about 2 weeks ago I started having pain in my knee.(Not sure if it happened after I was playing tag with my kids or what) It kept feeling like it needed to pop and hurt so I had popped it a few times but it didn't help. It kept getting worse over a few days to the point I couldn't bend it and it started to swell. I went ot urgent care and they put me on crutches and a knee immobilizer and told me to come back in a week if it didn't get better and sent me for X rays. Xrays were normal and then a week later the knee was really swollen and hard to bend so I went back in. They sent me for an MRI (which came back normal with no meniscal tears and ACL seemed fine) The urgent care doc said to go to an ortho and he saw me that week. He said that sometimes MRI's don't show the tears so his diagnosis was a mensical / cartliage tear until proven otherwise. (word for word) He gave me an injection that he said would numb my knee for 6-8 hours and wear off...he just wanted it to 'unlock' my knee. After doing that I came back in with the MRI films since he couldn't read the cd and he rushed in and out in 5 minutes saying he would perscribe PT and that it was still diagnosed as a meniscal tear until proven otherwise. (again, word for word) I am trying to walk on it but it swells with walking a little and I can't fully straighten my leg. Big problem is that I can't bend my leg back past 90*! it feels as though it will pop / explode / snap. It is almost like something is pulling so tightly on it and there is so much pressure (?) . I don't know what to do....Doctor said that if in 3 weeks the PT doesn't help he will see me again and talk about surgery and that even if I dont' get it now, he sees surgery in my future at some point still. Shoudl I get a second opinion or just go ahead and do pt to see if it helps? It is PAINFUL and bending it seems to get more painful and the degree to which I am able to bend it is getting less and less no matter how many times / how hard I try throughout the day. ::sigh::

 
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Old 05-31-2012, 11:58 PM   #2
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Re: Major Knee Pain .. Help!

Hi there -- welcome! I would definitely go to another ortho or sports medicine doctor for a second opinion and more answers. ("I'm not quite sure what's wrong with you, but you will probably need surgery" is not very helpful.)

While you are awaiting your appointment, you can make the PT appointments. Don't do anything that is painful, though, especially since you don't have a firm diagnosis. The PT may be able to help with light massage, ultrasound, gentle stretching.

Also, you didn't mention using ice/heat, but since you are two weeks post-injury, you should be able to alternate ice and heat, (still ask the dr's office). Fifteen minutes per hour, make sure that you protect your skin.

 
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Old 06-01-2012, 12:42 PM   #3
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Re: Major Knee Pain... Help!

Thank you so much for taking the time to reply! The radiologist read the MRI's and said no tear, then the doc said he saw no tear but that they don't always show up in MRI's and that is where he came up with that stupid line of 'meniscal tear until proven otherwise'. lol. I know there is something wrong besides the baker's cyst since it is in the knee more than the back of the knee where the pain is. There has to be something that is wrong for me to feel that much pain / pressure when bending. And when I walk on it, it seems to make the range of motion worse as far as bending it backwards. On top of it all, he got upset with me that after he gave me the PT referral on Friday afternoon that I hadn't had an appointment already completed with them by Wednesday (this being that it was a holiday on monday and they were already booked anyway! I even called today to see and the ones out here were all booked until mid June) So sorry, had to vent. haha.

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Old 06-02-2012, 02:11 PM   #4
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Re: Major Knee Pain... Help!

Sometimes things don't show up in MRIs unfortunately. Just because an MRI doesn't definitively show an injury doesn't mean it doesn't exist.

For example, none of my MRIs leading up to my third hip scope showed that my acetabular cartilage had delaminated from over half of the bone surface. Ouch! Fortunately, my hip surgeon had the experience to recognize the other clinical signs of delamination and performed a surgery to try to repair it. (Still waiting for full recovery.)

Delaminations in knees and hips often don't show up in MRIs, and the tell-tale symptom is a feeling of "giving-way". Sometimes, a delamination can be picked up when the MRI images are re-reviewed, so I would certainly ask about this possibility if you are having symptoms of giving way.

If you are near San Francisco, I would definitely recommend a consult with Dr. Warren Strudwick. He specializes in knees and shoulders. He has always listened to my subjective complaints. He also showed how to read an MRI, and what all the different images mean. I have talked to other patients of his whom I met at the gym by happenstance who have all been very happy.

Of course, second and third opinions should give you a full picture of what's going on, why the suspected injury isn't shown on imaging (or why the first surgeon didn't catch it), and what your options are.

 
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Old 06-02-2012, 10:05 PM   #5
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Re: Major Knee Pain... Help!

Hi Mamatofour -- I think that your MRI showed no definitive injury. I want to clarify my earlier post. Sometimes orthos and radiologists miss an injury. In the alternative, even if nothing shows up on your imaging, that doesn't mean you don't have an injury. Keep pushing for answers. Don't let a doctor try to short-change you in getting an accurate diagnosis.

 
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Old 06-03-2012, 03:54 PM   #6
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Re: Major Knee Pain... Help!

Thank you so much I know that there is something that the MRI is either missing or that is being misread / not picked up on. my doctor said that there are cases where the MRI's dont' show because of either positioning or what not but they do an arthroscopic surgery to reveal that there is in fact something wrong inside. (Of course, that is the doc that I am questioning in the post so I am so confused as to what to think from what he says. LOL) I am beginning to wonder if a piece of cartliage or fragment of something has come lose and is floating around causing me pain inside? i have my first PT appintment tomorrow morning and am nervous to go for fear that it will do more damage before I get a second opinion but then fearing postponing treatment will make the the doctor refuse to do anything until I have had X-amount of PT visits. Last night I was sleeping and had a muscle spasm in the middle of the night that caused me to kick my leg back and I woke up crying from the pain. It felt as though someone had taken a hammer to my knee (noooot the way I like to get woken up. haha) I also feel 'crackling / creaking' in there and an occasional pop every so often when I walk on it. I am having such a hard time finding another ortho out here that gets good ratings. The one with the best ratings is my one I have already seen! i am going to take advice and call tomorrow to our local University Medical Center and get their recommendation and go with that. I LOVE this UMC out here (just built and by far one of the best hospitals I had ever been to when I went there to have my daughter and again int he ER with her for ashtma) Hopefully they will be able to do something. I love the suggestions and input from everyone, i can't thank you guys enough!

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Old 06-04-2012, 11:06 PM   #7
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Re: Major Knee Pain... Help!

Oh I def. will call them first thing tomorrow!! I am so sorry you had such a bad experience with your doctor, that is terrible!!!! Some people (doctors) are ridiculous!!

I wanted to tell you what happened today, too! I went to my first PT appointment hoping they coudl give me some more insight or something. (My biggest fear was that no one would even touch me if I dind't go to one saying 'go and if it doesn't fix it we will help'. ugh!) I didn't want them doin gany exercises (which they didn't) but told her what the doctor said. He told me that i DID NOT dislocate my patella which is what the urgent care doctor thought. He said that at the first visit as well as the second after looking at hte MRI films. then, what does he write down on the paper for PT? HE SAID I DISLOCATED MY PATELLA!! To me that seems dangerous that he would write that down if I didn't (and he showed me that there was no trauma at the area a dislocation would happen in my knee on my films!) He said 'meniscus tear until proven otherwise'...and made a point of saying it wasn't that. I dont' know. Isn't that horrible?!

 
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Old 06-05-2012, 12:02 AM   #8
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Re: Major Knee Pain... Help!

So the diagnosis on the prescription for the PT was dislocation of the patella but the doctor verbally told you that there was no dislocation and he is assuming meniscal tear? How confusing is that?

I always get copies of all my records myself. That way, I have them at a subsequent doctor's office and none of the support staff can claim to have lost anything. (A little of this is from previous experience and a little is because I am a control freak.) If you end up at an ER, you also can bring all pertinent records, time allowing. I would ask for all the doctor's visit notes, so you can try to figure out what's going on. I hope you get some answers soon!

 
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Old 06-10-2012, 10:52 AM   #9
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Re: Major Knee Pain... Help!

Sooo....sorry for the late update. I went back in and the orthopedic doctor said that I need to have surgery. I am going to have a 'possible meniscal repair' and 'plica removal' in 2 weeks. My knee is hurting worse these past few days and is starting to throb even when I just sit so I am happy we are doing something about it! Phew.....at least there is possibly an end in sight lol. Thanks again for everything!

 
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Old 06-10-2012, 07:55 PM   #10
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Re: Major Knee Pain... Help!

Thank you so much!! Apparently the plica is the appendix of the knee that can cause pain and mimic meniscus tears or can become inflamed and be pinched due to injury when movement happens in the knee . . . I guess he wants to be sure he covers all bases at once. lol. I am just so excited that they are going to finally do something! Best of all it is at the hospital that I LOVE (there are 4 hospitals close to us, this is the university m edical center I had my daughter at and fell in love with) Tuesday will be 2 weeks until surgery so I will keep everyone posted I can't thank you all enough for the input and help!

 
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Old 06-27-2012, 02:50 PM   #11
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Re: Major Knee Pain... Help!

Hi!!! So...here is an update:
Went in for surgery yesterday. He said it woudl take about 30 mintues, then an hour in recovery and I would be able to walk same day and go home.....He got in there with MRI's in hand (you know, the ones that showed nothing wrong. lol) Well, turns out that I had a giant piece of displaced torn floating cartilage that had flapped into my joint space causing so much pain. He took that piece out and did a bunch of micro fractures to hopefully allow for my cartilage to regrow in there. I remember waking up from anesthesia and him telling me some of this and the first thing I said to him was, ' so I wasn't being a baby for nothing?' LOL. I knew there was somethign wrong, and I was the case where the MRI showed nothing apparently. So happy I found a doctor who was willing to go in and fix it rather than just wait it out. Now I'm not allowed to walk or put any sort of weight on it for a month - 6 weeks depending on how fast my healing begins. Such a relief that this is finally done!! They put a block in my knee so I wojldn't feel any pain when I woke up but it is finally wearing off so I feel it throbbing and aching and lots of muscle spasms but thankfully the vicodin takes the edge off enough so I can rest comfortably. Thanks again for everythign!!!!

 
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Old 06-28-2012, 12:18 AM   #12
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Re: Major Knee Pain... Help!

Another delaminated lady! I fully understand the type of pain you were experiencing. The buckling and delamination seem to be strongly linked and difficult to pick up on MRI. I had a delamination in my right hip -- between my first and second surgery, I was sitting in a chair and heard a sound like a thick towel tearing coming from inside my hip. I thought I might pass out.

For my third surgery, the doctor performed a similar procedure to yours. Since about half the cartilage had pulled away, he could not remove the flap. He placed plastic anchors around the edge and microfractured under the cartilage to promote reattachment. Well, the microfractures came first sequentially...

Be very careful with your recovery. Each surgery is slightly different -- I was to bear as much weight as I could to act like a pressure dressing inside the joint. Listen to all of your surgeon's directions, since this is your best chance for a healthy knee. Be very, very careful if you need to negotiate stairs. Your doctor might have a recommendation on supplements -- MSM and glucosamine are the most common. Get plenty of rest!

 
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Old 06-28-2012, 08:48 AM   #13
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Re: Major Knee Pain... Help!

Hi there!

I don't know if mamatofour's surgeon will allow her to take any cartilage supplements until she is fully healed. They could interfere with the healing process. Plus, the two most prescribed liquid cartilage injections, Synvisc1 and Euflexxa, are not usually approved by a lot of commercial insurance companies because these two drugs do NOT have a long term proven track record of successful treatment in comparison to a total knee replacement. Because TKRs have been done for almost 40 years with a 90%+ rate of successful recovery from osteoarthritis, the insurance companies would rather pay for the $50,000 (per knee) TKR surgery with its proven successful track record than for a drug that's only been around for a couple of years and doesn't always last very long! I know that was the case for me. (I couldn't take the Synvisc or Euflexxa anyhow, regardless of the fact that my insurance company rejected my surgeon's claim for it, because I was allergic to the chemical family of drugs they were in. So the point became moot.) Besides which, as previously noted in my many past posts on this board, I had "end-stage' osteoarthritis in both knees and the ONLY cure for it was having both TKRs a year apart. I got excellent results after both surgeries because I DID do everything that was asked of me by my surgeon and physical therapist!

Just thought you guys might be interested in this little tidbit of info.

Regards,
Carol (*******)

 
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Old 06-28-2012, 06:29 PM   #14
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Re: Major Knee Pain... Help!

I suppose my last post may have been vague. I was referring to nutritional supplements, such as MSM and glucosamine. Some doctors recommend these supplements to help with healing from the microfracture proces. Other doctors think these supplements are a waste of their patients' money. Of course, please ask your doctor his opinion and follow his instructions carefully. Happy healing!

 
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Old 06-28-2012, 06:37 PM   #15
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Re: Major Knee Pain... Help!

I agree with you! Usually though, you're right that MOST Orthopedic surgeons probably would not suggest the over the counter supplements because by the time a patient comes to see them, it means they have little or no cartilage left and the patient is not far from needing a TKR! So, yeah, it WOULD be a waste of the patient's money.

Knee and hip patients are better off just following their surgeon's instructions. Of course, they are free to do some research and present alternate therapies to their surgeons. If the surgeon feels their problem is too far along to warrant trying OTC supplements, he or she will let the patient know that. At that point, the patient, if they trust the surgeon completely, should just go along with the surgeon's recommendations for treatment.

Carol

 
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