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  • knee enfussion, clean xray, mri shows only obvious swellin

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    Old 10-20-2010, 05:29 AM   #1
    kijopainthorse
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    Angry knee enfussion, clean xray, mri shows only obvious swellin

    Feeling a bit frustrated. 24 years ago I had bilateral knee surgery. Lateral releases, fatty pads were trimed, and membrane linings were flipped under on both knees. Done pretty good since with little swelling behind the knees from time to time. Six weeks ago my left knee swelled over a twenty four hour period. Ten days later I had been in enough pain I was going to the orthopedic doctor. I could not bend my knee, there was alot of pressure and pain midline. At the apt. the doc felt that I had cartilage damage, from the physical exam. I had a clean xray of both knees. So options were one-drain, cortisone-and brace, or two do an mri. Doc felt that swelling was enough to warrent a mri, feeling it would confirm his exam. Well, mri came back saying that there was only obvious swelling , no damage to anything. So I go back ,and we did option one, drained 50 cc, shot of cortisone and braced it. Ten days later, I could not bend knee again,(the first draining was good. normal fluid color., no pain , and relieved the pressure for two days). Went back to the doc, he wouldn't drain it again, and obviously it was full of fluid again. Sent me for blood work to check for all the inflamitory diseases, and lyme disease. Put me on Feledene and will visit him again next week. I am feeling really frustrated. The pain midline gets pretty intense at times. I can climb stairs this week, but wouldn't want to do it in public! I can not go done stairs. I can not bend the knee past ninty degrees without forcing it and being in pain. It knee is popping alot throughout the day, which is not normal for me. Help! I just want to get back to life. Getting through the day is difficult alot of the time. I experience alot of pain and discomfort when totally straightening my leg, after long periods of sitting. The best position for my knee is slightly bent.

    Last edited by kijopainthorse; 10-20-2010 at 05:48 AM. Reason: added information

     
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    Old 10-20-2010, 10:10 AM   #2
    jennybyc
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    Re: knee enfussion, clean xray, mri shows only obvious swellin

    If your MRI is clean and they found no signs of infection in the joint fluid(they usually send it for testing whenever they take fluid out)they you need to figure out what is wrong and the possibilities are numerous. Could be an inflammatory arthritis or gout(ask him if they tested the fluid for crystals).

    But here is the bottom line. If it's not something mechanical(like cartilage or ligaments) then consider seeing a rheumatologist to find out what it is. They are the medical side of orthopedics...the arthritis docs. They medically manage what the orthos can't fix.

    I had both of my knees blow up earlier this year and it turned out to be gout. And I've had both knee replaced from osteoarthritis. Somehow it doesn't seem fair that after having the knees destroyed by OA that I turn around and get an even more painful problem with the replaced ones.

    good luck...............Jenny

     
    Old 10-22-2010, 05:16 AM   #3
    kijopainthorse
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    Re: knee enfussion, clean xray, mri shows only obvious swellin

    Thanks for the reply.
    I have gotten my blood test back and ana is negitive and the ra factor is in the normal range for a normal person, but the sed rate is high. I see the doc on monday to discuss our next steps.

     
    Old 10-22-2010, 09:30 AM   #4
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    Re: knee enfussion, clean xray, mri shows only obvious swellin

    That doesn't mean much actually. There is an entire group of inflammatory arthritis' that are called "Sero-Negative" and the basis for the diagnosis is that no test are positive except the sed rate. It may rule out a couple of things but that is all. There are over 100 types of arthritis and the list grows yearly.

    Sounds like you may be headed to a rheumatologist to try to figure this one out...and it may take time. These docs are the true mystery solvers of medicine. But at least they will usually treat you for the pain while trying to figure it out.

    good luck.................Jenny

     
    Old 10-22-2010, 02:38 PM   #5
    kijopainthorse
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    Re: knee enfussion, clean xray, mri shows only obvious swellin

    I guess i am a bit confused then, why run these tests if you can't use the info from them. I have been told that the sed rate can be high even if you have a cold or inflamation of any kind. It doesn't have to be linked to a specific disease of any kind. I still feel like there is something mechanically wrong in the knee. I have also talked to many people who's mri 's have said there is nothing wrong and then they scope it and find more than one thing wrong. My knee still tests positive for cartilage damange with the physical exam. It wants to give out to any bump. I guess I will see what the doc says on monday.

     
    Old 10-22-2010, 05:36 PM   #6
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    Re: knee enfussion, clean xray, mri shows only obvious swellin

    Yeah, you need to talk to the ortho and see what he thinks you should do next. And arthritis does cause mechanical damage.....that's why I have metal and plastic knees now.

    As for the blood work, they do it just to see if anything jumps out. A high white blood cell count might mean an infection. A positive ANA would mean you might have lupus, a disease that affects men rarely but has a different presentation than in women. A positive rheumatoid factor can mean rheumatoid arthritis. But the sed rate is a marker for inflammation anywhere in the body and is about the only blood test that is positive in this group of arthritis disorders that tends to affect men far more than women. That is when the lack of positive blood work actually is diagnostic. So rather than just being negative, it points to one of the disorders that features negative blood work except for the sed rate.

    But arthritis, in the absence of a mechanical problem takes time to figure out....weeks, months and even years.

    All you can do it trust the ortho that he has done a thorough job in checking for any mechanical problems that can be fixed and when he has thoroughly exhausted that avenue, then you go down the arthritis avenue....and that can be a long road.

    But the blood work is diagnostic even if it's negative....one of the only times a negative result can actually mean something. With arthritis, it's all about eliminating all the possibilities until you find the one that fits. Very few direct tests to confirm anything.....you just eliminate the others.

    Let me know what the ortho suggests. I'd be interested in knowing what it turns out to be. And I hope whatever it is, it's fixable.

    Jenny

     
    Old 11-09-2010, 11:47 AM   #7
    kijopainthorse
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    Re: knee enfussion, clean xray, mri shows only obvious swellin

    Update....
    Saw rheumatologist. Still frustrated. original blood work, sed rate a bit high at 30, ana negitive, ra normal range, cbc otherwise normal, lyme test was equivicoal. Rheumatologist ran western blot =negetive, crp is high , and ccp is normal. NO on can seem to come up with a diagonsis. The only thing that seems to be showing up is that there is inflamation on the blood test and obvious swelling in the mri. ugh! I think its about time for a scope on the knee. There is still fluid build up in the knee joint-debating wether to drain it as it just returns within a couple of days.

    Ok, spoke with doc today. Took me off antibiotic seeing the western blot test was neg. Confirmed that the next set of ra factors were normal and no signs. Knee still has fluid in it.
    Left message with orthopedic about all tests and he should have a copy of them. May run labs on fluid but looking at doing scope to see what is happening with the synovical lining. This was one thing that was corrected during my surgery in 84, lining was flipped under on both knees. So just feeling frustrated, wanting to be back to normal.

    Last edited by kijopainthorse; 11-12-2010 at 04:34 PM. Reason: talked to doc today.

     
    Old 11-09-2010, 12:55 PM   #8
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    Re: knee enfussion, clean xray, mri shows only obvious swellin

    I feel your frustrations. I injured my knee 2 years ago- the dr went in to do a lateral release since nothing was found on the mri and found my meniscus was torn. 2 years later. same thing. cortisone shot wont even work this time. xray showed a little arthiritis but the dr wants to go in to make sure nothing else is damaged. he thinks I tore another ligament due to tests and exams. It sux when they dont know what is wrong. I would really consider having a scope done to see if maybe something is wrong mechanically that isnt showing up on the mri.

     
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