Knee-Pain Mystery

[WannaBeNrse]

Hi,

I am not looking for medical advise, just some ideas maybe.... I am just a little frustrated right now. I have had trouble with my right knee for about 7 years now. It started when I was about 19, with pain and stiffness during long car rides. Then after a few weeks, the pain suddenly disappeared, and my knee didn't bother me for a while. Then it would come back. At 23, it got so bad that I saw an orthopedics specialist. He took x-rays, and determined that there was a slight abnormality in my knee joint, some bone was shorter than it is supposed to be (at the time i didnt know medical terms and did not ask for details). He said it was no big deal, but I should avoid high-heeled shoes. So over the years, the pain came and went, and now this summer it got really, really bad. I started working at a nursing home, and even though my knee does not bother me all that much during work, it hurts terribly whenever I have to bend and unbend it, and the pain is very bad during the night and in the morning. The more active I am during the day, the worse my knee gets at night. It also makes clicking sounds when I walk up and down stairs and when i ride my bike. It does not hurt with regular activity, though.

Last friday, I finally went to see a doctor (not a specialist). He couldn't find anything wrong with my knee during the physical examination. Initial arthritis screening was positive, but the confirmatory test was negative. X-rays appear normal. But I am still in pain. He sent me home with naproxen and prednisone, but no real answer. I am just frustrated, because I am only 26 and this knee-pain is really debilitating. I cannot afford to go from dr. to doctor. With all the lab work and x-rays, this visit will probably add up to $500, and I still don't know what's wrong with my knee. I am thinking maybe it's chondromalacia patellae, or a reactive localized arthritis (not rheumatoid), but wouldn't that show up on x-ray? Any ideas on where i should go from here?

Thanks!

[Marie_LPN, RN, LPN, RN]

I'd go sede an orthopedic doc, one who's clinical interest is in joint pain or sports medicine.

[llg, PhD, RN]

Hi,

I am thinking maybe it's chondromalacia patellae, or a reactive localized arthritis (not rheumatoid), but wouldn't that show up on x-ray? Any ideas on where i should go from here?

Thanks!

Where do you go? ... If the pain is bad enough, you should see an orthopedist.

Patellar chodromalacia won't necessarily show up on a routine x-ray. Mine never showed up any x-ray -- but it was diagnosed with an x-ray with my knees put in a weird position that showed that my bones didn't line up right and were therefore scraping when I put weight on them when they were bent. The regular x-ray taken by my PCP didn't bend the knee and show the "crookedness."

Unfortunately, for me, there was nothing that could be done other than avoid any movement that caused the bones to scrape. That was 20 years ago and I expect to be going to an orthopedist one of these days. I think my knee joints themselves are in good shape -- but the soft tissue around them is shot. I suspect I have little stress points in tears that may need treatment. Almost any type of movement hurts now.

Good luck. See an orthopedist if it is bad enough to see a physician.

[P_RN, ADN, RN]

Did they check leg length differences?

I had to quit driving a straight shift car cause of chondromalacia. It was just as you describe it. But guess what fixed it? A 'felt cookie' in my left shoe heel, and an exercise of lifting my foot off a footstool, holding it up then lowering it slowly to the floor. Then back to the footstool slowly, then lift up.........

It worked IF you have chondro. You need to see an ortho though. Chondromalacia is a pretty specific dx.