Help with Diagnosis + Treatment

Posted , 6 users are following.

I've been wreslting with major knee problems for the past six months. Here is a list of symptoms and causes: 

?a. Sharp pain shoots down the inside fo my right knee if I squat low enough. (I'm pretty sure this is indicative of a Grade 1 Sprain of my MCL). 

?b. I've been diagnosed by a surgeon with Patelloformal knee syndrom on both knees. However, no amount of physical therapy is actually making them better. 

?c. There are moments where I attempt some cardio activity, and the outside of my right knee will shoot with pain and weakness. 

?d. I've taken an MRI, and it shows zero structural damage.

?Can anybody help me figure out what's going on, and why I'm not actually getting better?

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13 Replies

  • Posted

    Patelloformal knee syndrome is usually very painful. Did the ortho make recommendations for how to remedy your problems?  I'm having partial knee replacement on September 14, but my surgeon's philosophy is that knee surgery is elective surgery.  You determine when it should be performed based on how much it has impacted the ability to do the things you love to do.  I'd go back to your surgeon, or find a new one, and tell him you're ready to find solutions to your problems. 

     

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  • Posted

    Go and ask the doctor to diagnose and rectify your problem for you when and if you are operated on im sure we can then help you with support for aftercare 😁

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  • Posted

    I too had this happen to both knees a couple of years ago after extreme physical activity, hiking, daily tennis etc.  I then flew a 20 hour flight and both knees were extremely painful and I could hardly walk.  I went through a regimen of therapy and recovered my right knee.  My left knee was already bad and had been for 20+ years.  4 months ago I had a TKR on the left knee. 

    This is some information I found:

    The population most at risk from PFPS are runners, cyclists, basketball players and other sports participants. Onset can be gradual or the result of a single incident and is often caused by a change in training regime that includes dramatic increases in training time, distance or intensity, it can be compounded by worn or the wrong type of footwear. Symptoms include discomfort while sitting with bent knees or descending stairs and generalised knee pain. Treatment involves resting and physical therapy that includes stretching and strengthening exercises for the legs.

    Hope you get some relief, it does take time.  Doi not put a pillow under your knees, you need to straighten the knees.

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  • Posted

    First, understand that MRIs can often be inconclusive or show nothing at all.  Many, many years ago, I had four (4) knee problems...two each side...and four (4) MRIs.  None of them showed anything wrong.  Each time the ortho surgeon went in and found the problems: two torn menisci (one each side) and two ripped off femoral condyle cartilages (again, one each side).  BUT ALL THE MRIs WERE NEGATIVE!!!!!!

    Sometimes, they just gotta scope the knee...period.  Go find a good sports orthopedic surgeon...a group that works with your local pro and college teams.

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    • Posted

      That is very interesting about the MRIs! Very helpful indeed. I wanted MRI on my knee ideally but was not offered one, however knowing that they don't always show exact issues is helpful. When surgeon got into my knee he said bone was very worn and the TKR was definately worth doing. Even though my gut instinct and experience in the year run up to surgery told me everything was rapidly deteriorating, it is oddly rewarding when they get in there and see what a mess things are! 😀😁😃

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  • Posted

    Thanks for the sympathy and replies everyone. 

    ?I've been diligently applying physical therapy exercises to my knees. I am more flexible than I've ever been, and have strengthened the muscles around my knee... yet it has provided zero cure to my right knee, specifically.   

    ?I've gotten that hasty vibe from my Kaiser surgeon and don't altogether trust them yet. I keep hearing good things about sports injury surgeons, so I'll see what's out there. 

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  • Posted

    Oh, one thing I forgoet to mention: 

    ?I have full range of motion in my legs, which is why the doctors have consistently said "no structural damage." For that reason, plus pricings, I have held off any type of exploratory surgery at the recommendation of my doctor. 

    Is it possible to have structural damage WITH full range of motion and nothing showing up on the MRI??

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    • Posted

      After nearly 3 years of pain a few MRI scans and plenty of PT I have finally had my MCL repaired - pain similar to your description, also leg would give way when walking.

      find yourself a good Orphopedic Sergeon and he will do a few stress test on your knee to help determine what's wrong, took my Surgeon less than 10 min to diagnose - think it was Valgus stress test

      I had an arthroscopy of the knee to check everything else was ok and then they tested my MCL for weakness then repaired as required 

       

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  • Posted

    It's been even more time (9 months since the injury), and my physical therapist at Kaiser is coming around to the possibility that I could have structural damage. Despite increased strength and mobility in my legs overall range of motion, the pain on the inside of my right knee continues to be JUST as significant. Two sports doctors and an assistant have both looked at my MRI and said for all intents and purposes I am fine.  Within 8-10 weeks, I face the possibility of knee surgery. 

    ?Are there any nuances within types of surgery that I should bring up to my doctors? Obviously, whatever requires less of a recovery time is best. 

    ?Additionally, I have a short, 10 second video of my last self-physical therapy last night at the gym. It would mean a lot if I could email it to some of you, so you could look at the contrast between my right and left leg and let me know if, in your experience, it is still conceivable that the distinction in mobility and pain could be chalked up to PTFS. 

    Thanks so much! 

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    • Posted

      When I was in my fifties, I had four...FOUR...knee issues (two each side) that neither x-ray nor MRI could diagnose clearly.  All FOUR times, the ortho had to go in, find and fix the problems.  Two menisci tears and two femoral condyle cartilages ripped off.  It is NOT unusual to have inconclusive results from the imaging forcing the docs to scope the knee.  For me, it was 100% of the time.  Sit back and relax...they will figure it out.
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    • Posted

      Thanks CHICO MARX. 

      ?Unfortunately, sitting back and relaxing is the absolute last thing you want to do with a major hospital: you have to be a strong advocate and really push for what you're looking for. It's because they are skeptical of what I am articulating that I have had to keep prodding and poking and pursuing different opinions and lines of treatment.

      ?This happened previously when I had a torn shoulder labrum. Essentially, the first mandatory step is an X-Ray. However even though the X-Ray is not designed to show structural damage, I have -- multiple times -- received feedback that everything was fine and there was no structural damage. Even though it WASN'T SUPPOSED to show the specific injury that I was speculating I have!  All that is to say, if you anticipate procedures and assistance regarding some type of interpretative, NON obvious medical condition, you have to be somewhat of a trail blazer because in my experience, the doctors won't do much of the thinking for you. They simply have too much on their place.

      ?The tension I feel is that if and when I pursue surgery, it's going to be precisely with the same people that stated I didn't NEED the surgery in the first place. I'm somewhat fearful of a little, political conflict of interest. We'll see how it goes.  

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    • Posted

      I've had the opposite experience, especially since moving to Fort Worth.  My wife of almost 8 years was a nurse for 30 years; my ex was a pharmacist the 25 years we were together.  I'm an IT guy but I've learned to question everything...especially drug combinations.  My wife's daughter has been an ER trauma nurse for almost 20 years and lives here.  When we got to Texas, we asked her for a list of the top docs in FTW.  Armed with that information, we have never had anything but positive experiences...especially when my wife needed brain aneurysm surgery three months after we got here.  Only the best would do...saved her life.

      Because of our combined experiences, we dig deep into problems and work with our docs to get the expected results.  They're the experts...when some imaging doesn't show the reason for the issue, our docs automatically go to the next step.  Never seen one specialist here who doesn't...that's why they're the best in town, just as Rachel told us with her list.

      In that way, I guess we've been lucky and haven't had any pushback from anyone we've seen.  We work with them, they work with us.  They realize that they are talking to knowledgeable consumers who will double check everything to make sure we get the care we expect.  Yes...you really have to know your "stuff" but we've never had to fight for anything with the docs we see.  It's always about finding the root cause of the problem...and a good doc must be able to expose that and not let anyone just live with their pain.  When I got stenosis at L2/L3 last year, my neuro went from x-ray to MRI to CT/Myelogram with contrast (the "gold standard" spine test) and then a pain shot under fluoroscopy to double- and triple-check his diagnosis before a successful LLIF fusion.   That's how our docs care for us.  Trust is a two-way street.

      You seem to have it tougher than we do.  Just don't give up...make them justify their diagnosis and procedures.  Make sure you come out of this whole again.

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  • Posted

    Hey everyone, 

    ?I recently had arthroscopy a few weeks ago. The exploration yielded no structural damage, yet my right knee pain has persisted. I am beside myself... I've gone through all the physical therapy protocols, have had the minimally invasive surgery, yet my right knee refuses to get better. If you scroll up, all the symptoms that I've experienced still exist, yet perhaps with the add-on that my knees are even achier than before. It feels so intrinsic that there is something structurally wrong with my knee, but no studies have been able to verify this. I don't know what to do. 

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