The swelling just won’t stop

LimpingAlong

Help, information and advice would be must appreciated.
I am a 44yr old male. I have Osteoarthritis of my left knee. Total lost of cartridge on one side of my knee. Approx 6 months ago my knee inflamed massively after a short walk with the dogs. It has basically not gone away and has caused massive amounts of pain in all of my leg muscles and joints. 3 months ago I had an arthroscopy to have the joint cleaned out of all the blood etc. They also took biopsies of some strange looking matter in there which came back negative for anything sinister. I have been working on building up my muscles in the leg with the help of Physiotherapy. I have now been assigned to a Haematologist to see if they can explain the regular outbursts of inflammation in my knee even though the joint space is ‘clean’. I have been taking Naproxen daily for 2 years now (not sure it’s working to be honest)
Just wondered if anyone out there has anything similar or advice.

dreamdaisy

Something similar happened to me back in 1997 with a swelling left knee but no mention of arthritis back then. In 2002 it was finally (albeit reluctantly) medically determined that I more than likely had some form of auto-immune inflammatory arthritis. I still do (it likes to hang around) plus OA which was diagnosed in 2011. By 2002 my knee was 27" in circumference, a major operation removed all the solidified inflammation but six months later it started to return hence the conclusion it was an auto-immune thing.

Over the years I have learned that arthritis can be a complicated condition, having as I do a creaky foot in both camps. I see no reason to go into too much detail at this stage but I think the priority for you is to ask your GP for blood tests for auto-immune arthritis (the best known is rheumatoid but there are plenty of others available). This may not initially be conclusive but it's a starting point. I was 'fortunate' in that I was born with an anti-inflammatory condition (eczema) and went on to develop another when I was seven (asthma) so I was always a prime candidate for this nonsense. It can also start out of the blue, however, which is far more confusing. DD

[Deleted User]

Hi there,

Welcome to the forum, osteosarthritis of the knee can be very painful and can present a variety of symptoms making a clear diagnosis tricky. You've had an arthroscopy so that should have cleared that up but now there is a possibility of something else going on, as DD says blood tests are often used to positively diagnose autoimmune conditions, but I've not heard of being referred to a haematologist for that. If you have been left wondering you could ask your GP as they will have been sent the results of the arthroscopy along with what is going on. You can also ask your consultant to copy you in to any correspondence they make.

Here's a link to information on osteosarthritis of the knee. I had a knee replacement in January and I'm very pleased with the outcome, it's a big operation but the difference to my quality of life is well worth it.

https://www.arthritisresearchuk.org/arthritis-information/conditions/osteoarthritis-of-the-knee.aspx

Keep us in touch with how you get on
Take care
Yvonne x

dreamdaisy

I've had a thought, I wonder if the curse of predictive text struck? I type the word I know I want but my machine often sees fit to replace it with something totally different. Haemotologist / rheumatologist, you say tomayto I say tomahto . . . DD

LimpingAlong

Thanks everyone for you help and advice.
I am currently sat in a waiting room waiting for my bloods to be taken and analysed.
The Haematologist thinks they will come back normal but will call me if there is anything abnormal.
He has advised me to stop taking my high dose Naproxen as this


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stickywicket

Whoops! That was rather a dramatic ending, LimpingAlong. I hope nothing drastic happened. I also hope the haematologist is right and there is nothing untoward. Please let's know how it goes.

dreamdaisy

As far as I understand things haemotology is the study of blood and blood disorders and how anyone can predict results is beyond me. My bloods are taken by phlebotomists who never venture an opinion and if they did I would ignore it: I wouldn't expect my car mechanic to deal with dentistry and vice versa. It sounds as though you are very new to this medical malarkey - there's a lot of specialist terms and lingo which can take some getting to grips with. Are you based in the UK? Sometimes different countries use different names for the same jobs which can lead to confusion (always ours, never the poster's because they know what they are talking about and naturally assume the reader does too). Please let us know what the results show as and when you get them, we may be able to shed some non-medical light on any anomalies. DD

LimpingAlong

......Not sure what happened there. I had typed a lot more but obviously it didn’t post.

Basically- trail of Stop taking Naproxen as this drug can excel any bleeding that is happening in my knee. It’s only been a couple of days since I stopped taking it so too early to tell if this has had an effect. I’m due a flare up in the next few days so we’ll see if mister ‘red hot massive knee’ makes an appearance again.
My pain certainly hasn’t gone away and more importantly my movement is still very poor. Not good for the job really.


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dreamdaisy

The inflammation in your knee isn't blood, it's excessive production of synovial fluid, the stuff that lubricates the joints. DD

stickywicket

We seem to be talking at cross purposes here. You've mentioned a haemotologist and blood in your knee. I'll try to explain where DD and I are coming from.

Haemotologists don't normally have anything to do with arthritis. Those of us who have an autoimmune form of arthritis (My RA and DD's PsA) see rheumatologists who prescribe us medication which requires regular blood tests to check our iron levels, infection levels, bone marrow, liver and kidney function as the meds can impair all of these. We don't see haemotologists though. They are consultant specialists. We merely see phlebotomists ie people who can take blood. I think it's a six week course (Several of my former GP's receptionists trained to be phlebotonists) and they are in no way competent to pronounce on the results.

For our osteoarthritis, we simply see our GPs.

In no kind of arthritis, is it normal to have blood on one's knee. Yes, the knee swells (alarmingly sometimes) but that is synovial fluid, not blood. When mine was at its worst I had enormous syringes of the stuff removed. It is yellowish.

Even an arthroscopy is not about blood. It's about, to quote the NHS, “repairing damaged cartilage
removing fragments of loose bone or cartilage
draining away any excess fluid"
https://www.nhs.uk/conditions/arthroscopy/


I'm guessing that either you have got the wrong impression and confused synovial fluid for blood and you are simply having routine bloods taken to check for an autoimmune form of arthritis or, possibly, you are having some complication resulting from the surgery which means you have blood in your knee. It can happen but very rarely.

An arthroscopy can usually help to alleviate symptoms of osteoarthritis in the knee but it's not a cure. Your OA will still be there.

Certainly any NSAID, such as naproxen, can occasionally cause stomach bleeds. I wasn't aware they could cause, or intensify, bleeding elsewhere, though.

I think the only way you can get a clear story is by asking your doc what is going on.

LimpingAlong

Thanks to everyone for your support and advice. Reading a lot of posts on this app I realise that there are people in a lot more pain than myself. Even if I have been dragging my leg along as I walk since February. I must have taken me 2 mins get myself in the car today.
In a nut shell I don’t think I have RA and the blood tests will probably prove that.
With regards to my worry of blood in the knee joint space is because that is exactly what they found during the the arthroscopy (in fact the Physio was showing the internal photos of my knee to all her colleagues because she hadn’t seen anything like it before). I really hope it is just fluid because that will go with time hopefully. But if it’s blood, how do you get rid of that?
I haven’t had any extra flare ups so far but my knee is still huge. I am going to make even more of an effort to get to the gym and try and build back all the muscle loss I have had in my leg and also the cycling may relieve some stiffness and get some movement back. So I’ll let you know what happens below.
The problem that I have at the moment is the pain I have in my hamstring. It’s as if I’ve injured it (probably come from the strain it has been under from the funny way I walk) and I cannot straighten my leg without screaming out in agony. I am currently sat in the Gym wondering what to do because I can’t get my leg to rotate just once on this exercise bike even with the seat at its highest position. I was at least able to cycle 2 days ago.
Confused if I should be Resting my hamstring or Exercising my knee[emoji17]
Someone has just mentioned acupuncture to me. ????


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stickywicket

I would never totally rule out acupuncture as it helped me, extremely briefly, many years ago but it's not something I'd bother with again. When I say 'extremely briefly' I mean about 1/2 hr per session.

It's true that cycling would probably be good for the knee but I'd guess you're spot on with your feeling that walking awkwardly, because of the knee, is what's done for the hammy. It's now tricky because I suspect that what's good for one is bad for the other. Personally, I see the physio again - or any good physio. At about £35 per hour I consider it good value for money especially as ours don't push you to keep coming back, just give you the exercises after ensuring exactly what your problems are.

Here, in case it's of help, is what the NHS says about hamstring injuries and how to treat them. https://www.nhs.uk/conditions/hamstring-injury/

LimpingAlong

Thank you so much for the advice. I must have been reading your mind because I called another Physio today to book an appointment. They have been recommended to me by someone who had a similar problem. I do see a Physio linked to my operation recovery but I thought a second opinion can’t help. If they can get some improvement out of me then it will be money well spent.
I have a target set in my mind. In seven weeks we go to Florida and I refuse to be pushed about in a wheelchair (because my knee can’t take all the walking) by my children. I’m determined to meet my goal even if it has been 6 months since I last walked without any pain or limp.
Once again thanks for your help and support.
Currently sat with hot water bottle under hamstring and ice on knee[emoji30]


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stickywicket

I can assure you you need nerves of steel to be pushed about in a wheelchair by your children They regard it as great fun. I have done wheelies over rickety, sideless bridges, experienced my 'pusher' waving both hands in front of my face going downhill at speed and was nearly sliced in half once by a lamp post :shock:

It's a good plan but I'd suggest two provisos both of which would be best put to your physio. 1. Buy a neoprene knee support (Actually, you could buy one in the States) for difficult walking ie either long walks or walks on uneven ground. Don't overdo it as they encourage lazy muscles but they're good for supporting the knee at times. 2. Consider wheelchair assistance just for the airports. For me, it's standing and queuing which are the really tough bits and there's so much of that in airports. Not only do you get to sit down but you also (along with your fellow travellers) get whisked through security. I'd also check that your travel insurance covers you for the knee. If your surgeon signed you off you should be OK but, if you're waiting to see a consultant for the first time, that's the dreaded 'undiagnosed condition'.

I hope the physio can help. Please let us know how you get on.