I am an army officer (male, 47 yrs) based at Bikaner, Rajasthan, India. I am experiencing daily multiple episodes of shooting pain in and around my left knee cap region for the past three months. The pain is severe and at times resembles a wave of continuously ebbing and peaking pain that lasts for few secs. The pain generally occurs when the knee is in flexed position during rest. It is also observed that the pain emanates when the knee is tilted slightly laterally. The pain goes away with change in posture or removal of pressure. In addition, I am experiencing mild intermittent pains in other joints (elbow, hands, shoulder, hip, spinal vertebrae etc) of the body, which are not severe but nevertheless irritating. I also experience severe burning sensation at times in the joints region and other regions of the body which last for few secs. Army doctors (orthopedic and Rheumatologist) have variously classified the condition as early stages of osteoarthritis, psoriatic arthritis (due to occurrence of some psoriatic plaque type rash on left elbow and pitting of nails) etc. However, blood tests have been negative for RF, CRP, ESR, Anti HCV, CBC, CRE2, ALTI, Blood Sugar, Routine Serum, URCA and there has been minimal swelling. Hence, they have retracted from their diagnosis. The skin biopsy of affected area on elbow has revealed PRP but not psoriasis. The orthopedic says there is nothing wrong with the knee clinically. He says he can conduct arthroscopy and send a sample of the synovial membrane for biopsy to find out for other types of arthritis. He has advised physiotherapy but that doesn't seem to be helping either. In addition, he has prescribed an inj of Deponedol 80 mg, NSAIDs, and glucosamine capsules, but these too have not helped me much. I have been an active person all my life and had been playing golf, and doing swimming till onset of this condition. I am really confused wrt my medical condition. The MRI of left knee says degenerative changes Gde II in posterior horn of medial meniscus and some tibial spiking. The MRI of Right Knee says bony fragment from an earlier injury well corticated in the ACL and lax ACL with mild edematous changes and no interstitial ACL tear. Please advice why I am experiencing these pains, the name of disease/condition and what treatment should I take. Thanx, Col Vishal Bakshy. - Asked by v x on 10-Aug-2016 11:28:15
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Dr. Yezdani Haleema
MBBS,Fellowship in Intesnive Care Medicine | Critical care (Intensivists)
Languages known: English,Hindi,Arabic,Urdu
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MBBS,Fellowship in Intesnive Care Medicine
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Languages Known: English, Hindi, Arabic, Urdu
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Answered by Dr. Yezdani Haleema on 15-Sep-2016 22:19:55
Hello officer the problem you have is not just confined to one joint hence it is not a local disease but more of a systemic illness but iam surprised most of blood tests are ok i would suggest you to get pANCA C ANCA levels and Anti Ro factor doneSee Disclaimer