Painful, swollen knee - pseudo gout?

Posted , 5 users are following.

I've had osteoarthritis in my knees for many years.  Last week I had a trapeziectomy operation which was extremely stressful as the regional nerve block didn't work properly.  Three days later my right knee suddenly became extremely painful - throbbing - and swelled up.  I couldn't walk on it,  I've been using ibuprofen gel and paracetamol and it has improved very slightly today ((3 days in).

Considering the speed of the swelling and pain, does this sound like pseodo gout to you?  I had pain and swelling of the other knee six weeks ago, but it was nothing like this.  I'm thinking of seeing my GP to discuss it, but would appreciate your thoughts.

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  • Posted

    My first thought was this is related to the op... •until you mentioned the other knee. (Pseudo)gout moves from joint to joint - injury from ops doesn't!

    What you need is a blood test - after this attack has subsided as the tests arent accurate during. However, if the GP could prescribe you colchesine or something that calms the immune system - and it works - that points a finger at (pseudo)gout. I wonder though if it may be another arthritic condition?

    Anyone else any views / ideas?

    Good luck - get in to see the GP ASAP.

    • Posted

      Thank you for your reply.  Can you tell me what the blood test is for, please?  What will it show if it is pseudogout?  And why doesn't it show anything during an attack?  

      Thankfully, the swelling is going down somewhat, although still painful, and I've got an appointment with the GP on Thursday.  

    • Posted

      If have thought they want to check out your kidneys and live; as well as a blood urate test to eliminate gout.

      The proof of pseudo gout is I believe by taking a sample of the sinovial fluid in the joints.

      The reason for taking the blood urate after the attack is the bloodvurate levels fall during a gout attack, as the offending material presipitates into the joints in an attack.

      The best conventional pain killer is ibufren because it not only stops pain, but will also reduce swelling.

      Good luck on Thursday.

  • Posted

    Is this the knee you had surgery on?
    • Posted

      No, Sochima.  A trapeziectomy is to remove an arthritic bone in my thumb joint.
    • Posted

      Well,  of course it is! Was wondering how you could have such an operation on your knee, thought you were confused.

      So then this does sound like gout or an arthritis flare up.

  • Posted

    The swelling has slowly gone down, although my knee is rather tender when pressed, as I found out when the GP exanined it,  I've had a blood test this morning for urate levels and also kidney function.  He believes that, if the test is normal, then it will still probably be pseudogout, considering I've had two attacks within a few weeks.

    If so, do I just watch what I eat and go back if it flares up again?  Would it help to ask about a knee x-ray?  It was awkward that the flare-up happened over a weekend, as well as a bank holiday, as I didn't go to see a doctor,

    By the way, I also have kidney stones.  Is there any link?

    Thanks for your help. 

     

    • Posted

      Is there a link between pseudo/gout and kidney stones?

      Yes! It is a relatively common complication.

      What would concern me is - if you have kidney stones why did your doctor not look for the cause and discover the gout/pseudogout and give treatment. The stones are an indication that there maybe stone/tophus formation elsewhere in the body including organs and blood vessels.

      Bbendroflumethiazide is a diuretic - good for blood pressure, bad for gout pseudopout and renal stones.

      There is a conflict between these two issues. Can you not drop your blood pressure by getting to a perfect weight, exercise and meditation? If not I'd have no idea - maybe you should see a specialist.

    • Posted

      Thanks Rusty.  I think the kidney stones, whilst being monitored, have juat being seen as a given and the causes have never been investigated.  It's something I will definitely discuss it with my GP, as well as the diuretic.  

      I'm a healthy weight according to BMI guidelines, I walk fairly regularly and go to tai chi classes.  Perhaps my age (70) and family history is against me in this, as I've had high blood pressure for 20 years.  

    • Posted

      I am afraid with two ailments requiring different but contradictory treatments, plus your relatively advanced age, I have no ideas.

      Maybe somebody else on this forum has experience, after all it must be a common problem as both are so common?

    • Posted

      If you're a healthy weight and low BMI then not sure why you're blood pressure is high. Also you say you do Tai Chi, and you walk, all this contributes to lowering you blood pressure. Is your blood pressure high even with the medication? Have you had any heart surgery?

    • Posted

      Could just be family history (genes), high salt intake or perhaps not sleeping well or stress of some kind? It is worth thinking about - is the diuretic really necessary - good thinking Sochima?

      Smoking maybe, now or past?

    • Posted

      Rusty, high blood pressure is caused by several factors. 1. heart disease 2. Vascular weakness 3. Low oxygen  4. Stress  5. Heart surgery

      6. Medication putting strain on organ tissues not receiving enough oxygen 7. weight.

    • Posted

      There is a list as long as your arm that will cause high blood pressure - those you've covered - plus others like kidney problems.

      I don't think we can cover them all. I thought your suggestion that he may not need the medication for the blood pressure was valid, and if correct gets him out of the dilemma. It could just be genetic predisposition though.

    • Posted

      Yes, I agree. Some doctors are all about keeping you on medication even when you don't need it. But it's hard to say without knowing his medical history.

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