A knee with a history of injury (and probably arthritis) gets warm again

[asm]

About 2 years ago I had a sudden swelling in my knee, probably due to over-doing sports. It didn't want to subside, and I eventually ended up at rheumatologist's, who somewhat tentatively diagnosed it as autoimmune arthritis (not rheumatoid though). At that point I was only taking NSAIDs. This spring, after reviewing up-to-date MRI and ultrasound and testing synovial fluid, it was decided that since my knee no longer had the amount of fluid that stood out, no further action (immunosuppressive drugs that is) would be taken at that point, and I was advised to wean myself off of NSAIDs too and get back if and when my knee swelled again. I spent the last 6 months biking (up to 100k a day sometimes) and even occasionally running (up to 10k). I stopped taking NSAIDs too. Everything was fine.

Now, a year ago, when I still had my knee swollen, it often got warmer than the other knee in the evenings. Only in the evenings - the temp would start rising around 6-7 pm, stay like that for 2-3 hours, and then slowly fall down to match the other knee. From this spring when I last saw my rheumatologist it was weirdly quite the reverse - my ailing knee stayed dead cold (unnaturally cold I would say) all day long, while my healthy knee would get warm precisely in the evenings. Until the last couple of weeks... Now they changed places again - although my healthy knee is not colder than cold, it's definitely colder than my problematic knee. Again - only in the evenings.

Now, the reason I'm writing this is to ask whether warm temperature in the joint is always a cause for concern or whether it may just be an idiosyncratic type of thing that some people have and that I always had but didn't notice until I had it swollen. Possibly something related to circadian rhythms, since it's always in the evenings. Now my rheumatologist told me to get back with her if it swelled again, but so far it hasn't - it possibly will, but so far it only gets warmer in the evenings. Now, I will probably be scheduling an appointment anyway, but I doubt they will see me sooner than in mid-January. It would be nice having some peace of mind till then that warmer temp by itself especially while presented in this peculiar way (in the evenings) means probably nothing. 

Thanks.

[Brandon123]

I do think knees get warmer in the evening. I have noticed that both my good knee and my bad knee (patella cartilage damage) get warmer in the evening. However, my bad knee gets much warmer and also red and hot. 20 min of icing of the bad knee in the evening helps a lot, and makes them evenly warm (both still warmer than during day the day)

[asm]

Still getting weird temp behavior from the knee... When I saw rheumy earlier this year, I was told I shouldn't pay much attention to the knee getting slightly warmer if it's not accompanied by the swelling, changes in images/ultrasound, blood-work, etc. And then somewhere in mid-spring it stopped getting warmer anyways. But now it's back, but it's even weirder this time - it still gets slightly warmer in the evening, but if I go to the gym to pump some iron, it very quickly goes cold. Today all it took was ridiculous 15 minutes of chest and back exercises - I didn't even do legs. I suppose it has something to do with general sweating, blood circulation, etc. Any suggestions what could be going on here? Thanks.

[Louisamith]

Did you ever find out what this was? Im having these exact symptoms

[Celina1989]

I think this is very interesting for me as well. I do get a warm (hot) knee when inactive. If I nap for an hour I get a red, hot and irritated knee (not much inflammation though). If I get active again the heat goes away and knee turns back to normal. It started happening about a year post autologous chondrocyte implantation for a cartilage defect. Unfortunatly the new cartilage isn't strong enough so there is definetly some chondromalacia.   

[Louisamith]

I think this is very interesting for me as well. I do get a warm (hot) knee when inactive. If I nap for an hour I get a red, hot and irritated knee (not much inflammation though). If I get active again the heat goes away and knee turns back to normal. It started happening about a year post autologous chondrocyte implantation for a cartilage defect. Unfortunatly the new cartilage isn't strong enough so there is definetly some chondromalacia.

If you dont mind me asking, did you get a red and hot knee before you had surgery? Or is this something that only occurred after it? I get hot knees in the morning and the night and I am concerned I have chondromalacia

[Celina1989]

I think this is very interesting for me as well. I do get a warm (hot) knee when inactive. If I nap for an hour I get a red, hot and irritated knee (not much inflammation though). If I get active again the heat goes away and knee turns back to normal. It started happening about a year post autologous chondrocyte implantation for a cartilage defect. Unfortunatly the new cartilage isn't strong enough so there is definetly some chondromalacia.

If you dont mind me asking, did you get a red and hot knee before you had surgery? Or is this something that only occurred after it? I get hot knees in the morning and the night and I am concerned I have chondromalacia

Always feel free to ask I am now struggling with my cartilage defect for 4 years. The heat only started about 8 months ago when I was one year post my autologous chondrocyte implantation. I have had surgery before (microfracture) but my knee never reacted by warming up while being inactive. I think it is really strange. PT thinks it might have something to do with my knee constantly being irritated over the past years and therefore not reacting normal. It kinds of need a reset but that is not possible now since the defect is still causing irritation on a daily basis. Ice is really helpful. My knee actually warms up so badly that it woke me up every night and caused me not to be able to fall back asleep soon (because if the heat is there for too long it really badly irritates my knee). I have now been using an ice machine with a timer that cools my knee every hour for 10 minutes to prevent it from heatening. Works so well fortunatly!

[Brandon123]

I have now been using an ice machine with a timer that cools my knee every hour for 10 minutes to prevent it from heatening. Works so well fortunatly!

Celina, do you have any link or further info on this ice machine? 

[Celina1989]

I have now been using an ice machine with a timer that cools my knee every hour for 10 minutes to prevent it from heatening. Works so well fortunatly!

Celina, do you have any link or further info on this ice machine? 

Yes of course. I am really loving this Polar Products one because of the timer and also the ability to just use frozen water bottles and also low water use.

https://www.polarproducts.com/polarshop/pc/Polar-Products-Active-Ice-3-0-Universal-Pad-Cold-Therapy-System-with-Programmable-Digital-Timer-9-Quart-Cooling-Reservoir-p32781.htm

The customer service is great as well! If you have any questions just ask please.

[Brandon123]

I have now been using an ice machine with a timer that cools my knee every hour for 10 minutes to prevent it from heatening. Works so well fortunatly!

Celina, do you have any link or further info on this ice machine? 

Yes of course. I am really loving this Polar Products one because of the timer and also the ability to just use frozen water bottles and also low water use.

https://www.polarproducts.com/polarshop/pc/Polar-Products-Active-Ice-3-0-Universal-Pad-Cold-Therapy-System-with-Programmable-Digital-Timer-9-Quart-Cooling-Reservoir-p32781.htm

The customer service is great as well! If you have any questions just ask please.

Thanks a lot for the info! That's some advanced stuff, much more so than my bags of frozen peas

[Celina1989]

I have now been using an ice machine with a timer that cools my knee every hour for 10 minutes to prevent it from heatening. Works so well fortunatly!

Celina, do you have any link or further info on this ice machine? 

Yes of course. I am really loving this Polar Products one because of the timer and also the ability to just use frozen water bottles and also low water use.

https://www.polarproducts.com/polarshop/pc/Polar-Products-Active-Ice-3-0-Universal-Pad-Cold-Therapy-System-with-Programmable-Digital-Timer-9-Quart-Cooling-Reservoir-p32781.htm

The customer service is great as well! If you have any questions just ask please.

Thanks a lot for the info! That's some advanced stuff, much more so than my bags of frozen peas

Haha, fancy, but also a real lifesaver, don't think I can sleep one normal night without it until the problem is fixed. During the day I just use my icepack if necessary, that is the coldest it can get I guess.