24M - Left Knee Pain - Need an informal 2nd opinion.

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24M, No Alcohol or Recreation Drug use. Currently on Pantoprazole, Famotidine, Symbicort, Proair PRN.

Chief Complaint: Left Knee Pain

Medical hx: Acid Reflex, GERD, Arthritis in both knees.

Arthritis Flare Up only in the winter time when it gets extremely cold, and the flare up only lasts 2 to 3 days. I normally just take Tylenol as needed and never really needed much medical attention for my knee or arthritis condition.

On 09/01/2021 I injured my left knee at work. I didn’t fall and I didn’t hit my leg, while I was lifting heavy items in a variety of different chutes my knee became extremely painful, and started to audible pop, and click.

My work is very physical and I am constantly squatting, twisting, bending. On 09/03/2021 I go to the orthopedic and they tell me that I have Patellofemoral Pain Syndrome. The doctor only presses on the knee to determine where the pain is but no imaging, no X-rays, no mri’s are taken of the knee. They tell me that it is a pain flare up. I explained to them that I don’t think it is a pain flare up because typically my arthritis flare up will only come for 2 to 3 days total and then complete disappear and I also said that the flare ups from arthritis only come during the winter time during frigid temperatures, I live in Minnesota so our Winters are Brutal. The doctor still just told me that it is Patellofemoral pain syndrome and doesn’t do any diagnostic testing. He told me to buy my own brace and refuses to give me a knee brace. He also told me to just complete a few weeks of physical therapy. He also put me on lifting restrictions where I can not lift more then 10 pounds and I have to do light and sedentary work. My work is unable to accommodate so they put me on a unpaid leave of absence. I have been using ice, bio freeze.

For the last week I have been in constant pain. No matter what position my knee is in the pain is constant. The pain gets worst with bending, walking up and down stairs, and squatting. Over the last week my knee also hurts when lying in bed. This is not normal and not typical. My knee also has an constant audible popping and clicking when walking up and down stairs or when squatting. The pain also radiates down the leg from the patella.

Since this is not my normal and since the doctor wanted me to follow up with him, tonight I had a follow up appointment, i explained to the doctor that this is not a typical flare up and that no body can tell me how my body feels and that I am the only one who knows my body the best and that I know when something is not normal with my body. I told the doctor that the pain is still present and that the pain is worst and that I can’t even sleep on my stomach because the pain from the bed would cause too much pain on the knee. I told him that the pain is not normal for me, he then just told me oh you are still have pain flare ups and that you need to stay on your restrictions and continue physical therapy. Again no diagnostic testing is done and the only thing that he does is put pressure on my knee to see me grimace and see my pain reactions. I am just frustrated because I feel like my orthopedic is not listening to me. What do you recommend that I do? I am frustrated because I want to know why diagnostic testing isn’t being done. I get it I didn’t fall and I didn’t hit my knee but there are cartilage injuries and other injuries (ACL tear, Meniscus tear, etc) that can happen. Can someone please provide some insight into this?

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