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Author Topic: Sore knees, no diagnosis  (Read 27318 times)

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Offline Snowy

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Re: Sore knees, no diagnosis
« Reply #30 on: July 17, 2010, 01:38:09 AM »
Wow - you really have been through the wringer. The only thing I can think of reading through your posts is that you may have returned to exercise too soon after the effective stretching regime. One thing my PT emphasized is that something like the malalignment I have isn't going to correct overnight, and that I would need to keep up the exercises and other measures (like the orthotics) long-term or even indefinately to ensure that the progress I made would last. A few days of stretching doesn't seem like it would be nearly enough to maintain an improvement, especially if you were working on something that had built up over the longer term.

It's tough when it feels like you've tried everything without getting any closer to a real answer. There will be a solution that works for you - just keep plugging away at it.
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline knee always hurts

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Re: Sore knees, no diagnosis
« Reply #31 on: July 18, 2010, 10:41:17 PM »
Yeah, well thanks for the moral support. I know that my problem was mechanical in origin. I just honestly don't think it is anymore. Do I think that getting my body into better alignment might help the situation? I do think so. And after the last month, a lot of my musculature has atrophied. But my fear is that this inflamed tissue is so damaged, that what has happened might be irreversible. It's really that bad. I know that this is usually not the case, but I'm still looking for some kind of opening, where I can go a few days without irritating this tissue further. I'm not sure I've found that opening yet. I'm not sure that's possible. But I'm not going to give up without trying everything. In the end, I might never be the same, but there has to be something that can be done. If there is, I've resolved to find it.

Offline knee always hurts

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Re: Sore knees, no diagnosis
« Reply #32 on: July 20, 2010, 04:26:17 PM »
I just looked at the calendar, and it's amazing to think that it has been over a month now since I could last walk. Every day seems to pass at an excruciatingly slow pace, but the days have still flown by. It seems unreasonable to think that anything I might do now will have an impact.

My mind is constantly mulling over all of the possibilities concerning my knee, and I experience constant anxiety. This morning I woke up with my heart pounding out of my chest, and my head has just been spinning all day. At points when this has happened before, I would resolve myself to try something different, with the hope that this might produce different results. As long as there is hope, my anxiety can subside. I think I've reached the end of my road now. There is nothing further I can do for myself. The next step is to see a specialist, get some scans done, and proceed from there. I hope I can manage well enough until I can see the doctor, but I think the next few days aren't going to be great, to say the least.

I've been looking this morning at the blog that highroller mentioned in one of his earlier posts, and went all the way back to 2005 to find a post about fat pad impingement. From reading it, this seems like a real possibility in my case. One of the interesting things about developing PFPS in my other knee has been that I've been able to compare the two knees. It turns out that the pain has manifested completely differently. My better knee, which didn't have any problem until recently, seems to be a more classic example of PFPS. It is quite achy, the onset was insidious, and the pains are around most of knee cap. In my other knee, it does ache sometimes, but the pain is far more sharp. The onset was acute, and the first time I ever experienced pain it was quite excruciating. Prior to that, I never had any pain at all. In addition, the pain is very localized, to one very small corner of my knee. Despite that, it is agonizing enough at times to really put a damper on my spirit. It's bad enough that I really can't walk without serious suffering involved. I've tried palpating my knee today, and to be honest, pressing down on my kneecap itself didn't produce much pain. If anything, pressing on the tendon below the kneecap seemed to hurt more. It's definitely not the tendon itself though, but something beneath it. Whatever it is, it seems to extend to beneath the kneecap as well. Interestingly, when I first had these pains, I thought it was some sort of tendinitis, and never considered that it might be the knee cap itself. Ever since the doctor diagnosed it as PFPS, though, I've been caught in that paradigm. Now a new thought has come to mind, though.

When I slammed down on the side of my foot way back in September, I have to presume that a huge amount of energy was transferred up my leg as well, and not in the anatomically correct fashion. It makes sense that the corner of my knee which is painful, is the exact place that would have taken the brunt of the force. Isn't it possible, that at this moment, the fat pad was compressed against the bone? The strange thing is that I didn't really feel any pain until a few days later, when I walked for more than 30 minutes. What is also strange is where to place that leg rotation issue in all of this. It's possible that the rotation was a preexisting issue, that only became a problem because the fat pad was then vulnerable after my injury. It is relevant to note that my other leg was also rotating when I was walking, but it was adducting rather than abducting. Yet this never caused any pain at all. It seems far more within the realm of possibility that my foot injury also injured my knee, rather than some mysterious, unexplained muscle tightening. It would also explain why I was continuing to have pain, albeit substantially less, even after a few days of stretching. The rotation did stop, but not the pain.

I know that all of this is just idle speculation, and you folks might think that I'm completely nuts for engaging in it, and not even having made an appointment to the doctor. That's just my personality I guess, I like to work through problems myself. I love to think through things, and even when I think I might be finished with it, I start thinking some more. I don't know if any of you are familiar with the Myers-Briggs personality test. It's a little pseudo-scientific, but I like it anyway. I'm an INTP. So that explains that. At least I have some things to mention to the doctor when I finally get there. The only thing I am certain of, is that this is something I won't be able to resolve myself. That's a difficult place to be in, but I'll just have to go with the flow. As always, I'll keep you all updated if there is any news or progress.

Offline kscope09

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Re: Sore knees, no diagnosis
« Reply #33 on: July 20, 2010, 04:35:27 PM »
You've made the right decision in seeing a specialist.  Looking back at my knee hsitory I wish I'd just seen a specialist in the first palce instead of all those gps and physios who treat me like a timewaster.  Saying that I would ahve been pretty frightenned if a specialist had told me to have scope early on as I was afriad of surgery.  It was only when I was at my whitt's end that I decided to go for it.

Let the specialist have a good look at it and get the scans done if he thinks you need them and myabe you won't need surgery, just a intensive course of pt.  Alos, I bet once you get the ball rolling and you know things are being dealt with I bet you'll start to relax.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline knee always hurts

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Re: Sore knees, no diagnosis
« Reply #34 on: July 20, 2010, 08:38:06 PM »
I just finished making the appointment, and fortunately I don't have to wait too long, as it's at 11:15 on Monday.

That's exactly how I felt at the GP. He didn't really seem to understand what I was going through. And at that point, it wasn't nearly as bad as it is now. I'm glad I won't be going back.

I'm just wondering if you can relate your experiences getting that arthroscope. Did you need general anesthesia? And how large is the incision? I suppose as far as surgical procedures go, it is on the less radical side or things, seeing how surgeons regularly crack open people's rib cages to perform heart surgery. But I've never had surgery before, and the thought of them making even a small incision still gives me anxiety. I'm still hoping to get through this without surgery, but I recognize now that I may be out of luck. If I want to find out what the problem is, I might have no choice.

Offline Vickster

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Re: Sore knees, no diagnosis
« Reply #35 on: July 20, 2010, 08:46:21 PM »
Scope portals are around 7-10mm each, teeny tiny :)  Usually done under general, but can be done with local, depends on the OS and anaesthetist.  Which country are you in?
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline highroller

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Re: Sore knees, no diagnosis
« Reply #36 on: July 21, 2010, 08:08:27 AM »
Just catching up here after a few days absence wallowing in self-pity :-)

Glad to hear you've decided to seek medical advice - we actually have our appointments on the same day! I sincerely hope that you have found a good practitioner as a lot can depend on that. What type of specialist did you opt for by the way - sports doctor, orthopaedic surgeon, etc? I may well be seeking a second opinion in the near future but we'll see what my OS comes up with next week. Perhaps we could document a checklist of items to address in our consultations here in this thread - I'll start jotting down some notes tomorrow.

My MRI revealed quite a bit of fluid accumulation in the fat pad which led to the sports doctor identifying it as the likely culprit back in Oct/Nov last year. At the time he felt that 4-6 weeks rest might be sufficient but mentioned that the fat pad can take quite a bit longer to settle down in some cases. When I returned 6 weeks later with no improvement at all he felt that fat pad inflammation was much less likely to be the primary cause. He had previously suggested that a cortisone shot would be the next step if the initial period of rest was unsuccessful but no longer felt that was the right course of action. Instead, I was referred to an orthopaedic surgeon who eventually performed an arthroscopy on my left knee (slightly the worse of the two) and excised some fat pad tissue but this was only a precaution against impingement was was not indicated by inspection of the joint. I would be very interested to see a current MRI of my left knee in order to compare the patterns of fluid build up vs 8 months ago. I guess I could have ongoing fat pad inflammation without prior or current impingement.

The location of my pain does not feel like it is emanating from the fat pad, at least not directly. It feels more peripatellar as well as partly originating at the interface between the femur and tibia. Not at all localised to any specific points.

Regarding surgery, I totally understand your anxiety, especially as you haven't had the pleasure previously but I can tell you that the arthroscopy procedure was a fairly straightforward affair in my own experience. I had a general anaesthetic. The incisions and the resulting scars are very small and barely noticeable. There was considerable swelling for a few days after the op - my knee made the most unpleasant flatulent sound when I bent my leg for a week or more! I gradually returned to weight bearing status over a week and was even able to walk home a couple of km's from my follow up appointment 2 weeks after the op. In my case though very little was actually done - only a small chunk of fat pad was removed - so the experience will vary a bit depending on the repair work conducted. There is some minor residual numbness in a couple of small areas around the incisions - sensation seems to be slowly returning over time.

As for an update on my own recent activities, I have been performing a sequence of low intensity leg exercises 2/3 times a day. I find the inverted position (shoulder stand using elbows for support with hands at the back of hips) to be the least stressful for knee bending movements - I do a kind of inverted squat and a bicycle motion. I also do some leg raises, leg slides and a leg curl while lying on my stomach - for the latter I raise my knees off the ground slightly when fully extended. I'm not approaching any kind of muscular failure on any of these exercises but I'm aiming to increase the repetition count day by day. I'm also doing some basic mobility exercises such as arm circles, etc to try and counteract the ravages of the sedentary lifestyle on posture and range of motion.

I also went for a short walk on Monday and Tuesday. I wasn't sure that I would be able to do it or that it would be sensible to try but I was able to walk a couple of blocks and back by moving at an extremely slow pace with very short steps and sitting down periodically to rest. I managed to avoid the dreaded 'sharp pains' but the experience was quite uncomfortable throughout. I was quite anxious that I would collide with another pedestrian and lose my delicate equilibrium or be unable to continue walking but I eventually crossed the threshold of my rehab cave with great relief. This experiment has not triggered a flare up beyond the poor state my knees were already in but I'm not sure whether to call it progress or not. I'm still hobbling tentatively around my apt with grinding knees that always feel on the precipice of more excruciating pain.

I'm turning 40 on Friday - looks like I'll have to defer the full festivities to a later, and hopefully more pain-free, date but in the meantime I'll be prescribing myself a couple of bottles of anaesthetic from a good vineyard!
10/09: knees sore from gym, MRI ok, fluid in fat pad
01/10: knees worse, OS recommends PT
03/10: barely able to walk
04/10: arthroscopy left knee, no problems found, fat pad trimmed
08/10: begin PT, rheumatoid arthritis ruled out
09/10: neuropathic pain diagnosed, prescribed Amitriptyline

Offline knee always hurts

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Re: Sore knees, no diagnosis
« Reply #37 on: July 21, 2010, 04:54:39 PM »
You know, I think we ought to throw a pity party! Extending all the way from your birthday to mine on the 7th of next month. There's no greater cause for celebration than self pity, don't you say? So my cave or yours?

Just promise that you'll go easy on that anesthetic! It needs to last a couple of weeks, and besides, while that eternal slumber which may follow too copious a quantity of said anesthetic might sound appealing at first thought, since in sleep of any sort knees don't hurt, you just might have some good years ahead of you.

What strikes me in your case is that the OS seems to have been unable to pinpoint the cause of your anguish. What if conservative measures fail? How can they even perform a surgery, if they don't know where the pain is emanating from? Really, that's why I've been holding off seeing the doctor for so long. I just have my doubts about whether they'll be able to do anything for me. My expectation is a recommendation from the doctor to use a specialized brace, and he'll probably want me to see a physical therapist. What's the likelihood that this will improve my circumstance to any measurable degree? As long as the PT doesn't suggest squats as a means of quad strengthening, I suppose it can't much hurt.

You've mentioned in various posts that you've been implementing various light exercises for your knees. Do you feel that this has made a real difference? I've only been doing basic stretches and strengthening exercises, but more to just maintain my ability to attain an upright posture, rather than anything specific for the knees. My problem is that I seem to have trouble simply doing basic day to day functions without triggering those dreaded sharp pains. Though, on some days I don't have much of an inflammatory response, which gives cause for hope. I'm just afraid that doing more activity might just irritate the tissues more. But in your experience, do you feel that doing those exercises "conditions" the knees so that they can bear a greater load for the rest of the day? If not, I'm doubtful that they would help at this point. I know that doing exercises within the envelope of function should in theory increase that envelope over time. But if I just end up irritating my knee by walking anyway, then what's the point?

If you've able to do any unessential activities and come out of it feeling alright, then I'd call that progress. Just don't get too excited and suddenly increase the distance you've been walking. Keep at that safe distance for a while.

My specialist actually did a residency for Sports Medicine, and Orthopedic Surgery. I'll have to be careful that he doesn't try to push me into the operating room before a good attempt at other measures.

At least we have the pity party to look forward to in the days ahead. Nothing like a good wallowing in the mud of self pity to cool down all of those feelings of depression and anxiety!


Offline Lottiefox

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Re: Sore knees, no diagnosis
« Reply #38 on: July 21, 2010, 07:07:37 PM »
Hi,

Good news on the appointment. At least its a forwards move to fidning out what may be wrong.

Don't dismiss suggestions such as a brace or PT, especially the latter. A good PT won't just get you doing pointless exercises that aggravate the knee. They will begin by doing a full assessment of your alignment, posture, biomechanics, and strength in your existing muscles. Then they should start with the basics and see what you can achieve. Can exercises work? Yes - quite often, if they are focused for you, done as prescribed (and that means FREQUENTLY) and assessed along the way. A good personal trainer can often take the same approach if they are appriately qualified in corrective exercise and biomechanical assessment. (eg NASM trainers with corrective experience qualification). I have seen people with pretty significant knee issues improve their function ten fold through the right functional approach.

Might you stress the knee or cause irritation? Possibly, but this should be a minimal risk with the right supervision. But without taking a risk what is the alternative? Staying laying down for the rest of your life and wondering what might have been?

Your doctor should NOT push you into surgery - that is the last thing a good knee specialist should focus on. I can't recall if you've had scans or X-rays but these can be a starting point. You mention sharp pains - they may indicate something structural, may be cartilage damage, may even be an underlying fracture of some kind that has gone undiagnosed. But, yes, there may be nothing as such that is seen. BUT that doesn't mean you can't get improvement, lengthy as this may be.

I know how frustrating this whole experience is but you must enter any form of treatment with the mind set that it will help. Otherwise - no point even trying it in my opinion. I was similarly dismissive of a lot of things - til I tried them.  :)

Good luck

Lottie  8)
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline highroller

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Re: Sore knees, no diagnosis
« Reply #39 on: July 22, 2010, 12:52:26 AM »
Hehe, pity party sounds good, we'll have a 'joint' celebration then :-) If you are in the vicinity of Melbourne, Australia, feel free to drop by my convalescence cave at 7pm tomorrow evening. I will kick off proceedings with a lengthy speech bemoaning my predicament after which everyone will hit up the liquor stash. Once the alcohol numbs our aching knees, perhaps we can take advantage of our expanded envelope of function with some cossack dancing.

As for the exercises that I'm doing, I really can't say that I've noticed any benefit so far in terms of pain relief or expanded function. The cogs move slowly in the recovery process though and it hasn't been long since I started so I'll keep at it for now. Even if it's not helping to resolve the underlying problem at least it will help to counter muscle atrophy and deconditioning to some extent. There's a small gym for residents in my apartment building so I might also try some stationary cycling on the lowest resistance level over the next few days.

Lottie, that is encouraging regarding PT. I'm sure my OS will be pushing that again as the best course of action but I'd feel a lot more comfortable if I had some semblance of a diagnosis beforehand. Finding a competent PT will be a challenge as the industry seems rife with mediocrity. Certainly the PT I used earlier this year did not perform anything approaching the assessment that you described. Neither did my OS for that matter.
« Last Edit: July 24, 2010, 07:06:13 AM by highroller »
10/09: knees sore from gym, MRI ok, fluid in fat pad
01/10: knees worse, OS recommends PT
03/10: barely able to walk
04/10: arthroscopy left knee, no problems found, fat pad trimmed
08/10: begin PT, rheumatoid arthritis ruled out
09/10: neuropathic pain diagnosed, prescribed Amitriptyline

Offline knee always hurts

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Re: Sore knees, no diagnosis
« Reply #40 on: July 23, 2010, 04:21:10 AM »
Hey highroller,

I just want to wish you a very happy, pain free birthday, which I am in no doubt you will attain with judicious consumption of that heretofore mentioned grape beverage. Just remember, much like the envelope of activity for our knees, to get the right amount. Too little, and there will be no subsiding of pain; too much, and you'll be tumbling down onto that most sensitive place on your body (not being the usual place in your case), writhing in pain despite the analgesic effect. Get it just right, and the salutary benefit is achieved.  I hope I'm not putting a damper on the festivities, but I regret to inform you that I won't be able to attend this blithesome event, as I'm now comfortably (or uncomfortably, as I think of it, darn knee!) ensconced at my home in the suburbs of Boston, Massachusetts. If I wasn't nearly at the antipodes of your location, though, I think a bit of spirits, or some fine Australian wine, as the case may be, would hit just the right spot. My incorporeal presence will be with you, hoping that you will have many more, pain free birthdays, perhaps being achieved without resort to a quaffing of the vintner's finest Liquoreux. Rather, in the future may you enjoy it for its own sake. :-)

Offline knee always hurts

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Re: Sore knees, no diagnosis
« Reply #41 on: July 25, 2010, 05:02:40 PM »
Well, tomorrow is the big day at the doctor for me! I just want to thank everyone for their posts of encouragement, and all of the helpful information that has been conveyed over the past few weeks. This has been one amazing, sorrowful, rocky, roller coaster ride for me and it has been great to talk to others who are going through much the same thing.

I'm still not quite sure what I'll be asking the doctor tomorrow. I think first, and most importantly, is explaining how the nature of this disease has changed, transmogrified really, over time. There was a sharp break in symptoms in March, and it has never been the same. At first, it followed a normal pain response pattern. It wasn't surprising that a knee which was rotating severely with every step might hurt, even severely, after walking for a long period. Also not surprising, it recovered completely after a few days. Such was my condition for over six months. Then the sudden break. I think I must have irritated it while it still in its antagonized state. I'll never know for sure, but I think it was actually because of an exercise the doctor recommended. I was doing leg extensions, and it must have been too soon. Ever since, I've never been the same. It is an absurdity, I think, to call the conditions by the same name. There is barely any commonality between the two, with the obvious exception that they are both in precisely the same location. What was once clearly a bio-mechanical abnormality, is now a condition of highly sensitized tissues, perhaps a neurological disorder. And the doctor I'll be going to is a sports medicine specialist and orthopedic surgeon. What is the chance that he'll be able to deal with my condition? I think my only hope here is that tests come back with something clearly abnormal; perhaps something floating around in there that doesn't belong.

I've more or less tried it all. Right now I've been doing hip girdle stretches and strengthening, quad work, hamstring and calf stretches, all really to no avail. I feel like I'm walking alright, but it just doesn't seem to matter. Sure, my quads are still in a pretty weak state, but I should note that this was not the case when my condition worsened to its current state, but rather has been a byproduct of my sedentary existence since then. If the doctor recommends physical therapy, I'll give it a go. But this is only attacking the problem at the very periphery of what the problem is, while missing the core. Something is very wrong with the tissues inside of my knee. What exactly, I do not know. But I suspect that this is not something that will be amenable to simple physical therapy or bracing. I've tried a month of rest, and I don't intend to give up on this any time soon, but what's going to suddenly change?

I truly do wish that I wasn't so glum about my prospects at the doctor. But I really don't have much cause for optimism. Whatever happens, I'll post an update tomorrow telling you all how it went.

Offline Lottiefox

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Re: Sore knees, no diagnosis
« Reply #42 on: July 25, 2010, 06:07:29 PM »
Good luck tomorrow - seeing a sports medicine/orthpod is definitely the right way forwards. Be open to suggestions, but push for some proper investigations and evaluation of what might be going on with the knees. Leg extensions KILL my kneecaps, I have just started to progress to short arc extensions over a towel or foam roller which works the final bit of extension without too much stress on the kneecap. Leg extension machines in the gym however are just OUT fir good for me, they shear the kneecap way too much.

Let us know how you get on

Lottie  :)
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline highroller

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Re: Sore knees, no diagnosis
« Reply #43 on: July 26, 2010, 08:51:47 AM »
Thanks for the birthday felicitations. I restrained my inner dypsomaniac and imbibed an admirably moderate quantity of Merlot from my personal wine cellar (actually a cardboard box under the sink) but 'twas a pleasant distraction to focus on the palette rather than the patella for a change.

Anyway, thought I'd provide a quick update on my OS appointment as it may be of some limited use to you in advance of your own consultation.

In a nutshell, my OS feels he's not in a position to help me any further and has referred me to a rheumatologist as the next logical step. He feels that a clear structural cause has been ruled out and that the 'inflammatory' category of disorders, of which there are many, now need to be investigated properly. In my case, the problem is clearly not an overt externally observable form of inflammation as there is no sign of swelling but is a more subtle irritation of the joint tissues as per our discussions above. He also feels that fat pad inflammation is not indicated by the history and current state of my condition despite the oedema detected in my MRI.

I raised the tissue homeostasis model of PFPS and its chamption Dr. Dye. He's actually met the guy and is very familiar with his work. He regards Dr. Dye as a very intelligent individual but somewhat at the fringes of the profession in terms of his comparatively extreme views, practices, conservative treatment/rehab protocols and reluctance to operate (e.g. he might recommend avoiding sport for 5 years after an ACL tear if it takes that long for a bone scan to return to normal). That said, he doesn't dispute the explanatory power of the tissue homeostasis model although it leaves you with rather limited options in terms of addressing the condition.

I didn't specifically discuss a number of other items that I had on my checklist (e.g. synovitis, etc.) - they are now best deferred to the rheumatologist consultation which is scheduled for Aug 26. Frustrating to have to wait so long, especially as the initial appointment will likely trigger further tests and follow up consultations, but these folks are clearly in demand from our fellow hobblers.

I also got my knees x-ray'd as an input to the rheumatologist consult. I took the images home but the report will be issued directly to my OS. From what I can see the images look very similar to the ones that were taken over a year ago. There is a decent gap between the femur and tibia which is consistent with the lack of any  osteoarthritis evidence from my arthroscope. My OS detected some very mild softening of the patellar cartilage when probing it during the op and characterised its state as somewhere between grade 0 and grade 1 on the common 4 stage (I think) model of osteoarthritis degeneration. So not even chondromalacia patellae which would be level 1.

I am going to make a PT appointment asap as well. I'll be bringing a healthy dose of inquisitive scepticism to the consult but at the same time I'm open to any rational rehab protocols that mesh with my evolving model of the underlying tissue dynamics. Crucial to this is a conservative approach that respects the fragility of my condition and its susceptibility to setbacks and ongoing deterioration.

Anyway, I wish you the very best of luck in your own consult later today and look forward to hearing about the outcome and any further insights that you glean.
« Last Edit: July 27, 2010, 12:14:48 AM by highroller »
10/09: knees sore from gym, MRI ok, fluid in fat pad
01/10: knees worse, OS recommends PT
03/10: barely able to walk
04/10: arthroscopy left knee, no problems found, fat pad trimmed
08/10: begin PT, rheumatoid arthritis ruled out
09/10: neuropathic pain diagnosed, prescribed Amitriptyline

Offline knee always hurts

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Re: Sore knees, no diagnosis
« Reply #44 on: July 26, 2010, 08:50:45 PM »
It's good to hear about the birthday and the new appointment, highroller. Hopefully a rheumatologist will have better insight into your condition.

I have to say my own appointment is about what I expected. I could have written the script, really. I described my condition to the doctor, and he then palpated and also flexed and extended my knee. He said he thought that I had chondromalacia and perhaps that was irritating the tissues. He had me contract my quads and mentioned that there appeared to be some muscle wasting. He didn't order any other tests but suggested that I do a few weeks of PT with a follow up visit to his office in a couple of months. I suppose there isn't much else he could do for me, anyway, as I am obviously reluctant to have an arthroscope done that might not even be necessary. Truthfully, I was hardly able to get a word in edgewise, so I certainly didn't mention anything about Dr. Dye or any other theories for that matter. I'll just go with the flow.

The good news is that there are some signs that my condition has been improving the last few days. There was once a point when I couldn't even flex my knee at all without a sensation of a tremendous amount of pressure, as if I was lifting hundreds of pounds. I now have a full range of motion in my knee. Yesterday I walked for 15 minutes, though I was doing my best impersonation of how I'll be walking when I'm 95, and it didn't trigger any inflammatory response. I was also experimenting with advice on that saveyourself.ca E-book which suggested that some people actually fare better sitting with their knee bent. As it turns out, this seems to be the case for me. Of course, it's just my luck that my other knee seems to be irritated when bent. But I'm more concerned about my worse knee, so that takes precedence. When I can, I'll sit with the bad knee bent, and the far less bad knee extended.

So the only real change here will be going to PT. Let's see if I get the Lottiefox white glove treatment with fancy bio-mechanical analysis, or if they have me doing single legged squats while balancing on a unicycle and holding a 500 pound boulder. Perhaps after imbibing a bit of highroller's Merlot, just to add to the challenge. Got to strengthen those quads! I'll be in the strongman competition in no time!















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