How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 32157
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
5625079
Type Your Health Question Here...
Dr. Arun Phophalia is online now
A new question is answered every 9 seconds

Some years ago, when I was a gh school principal, I twisted

Customer Question

some years ago, when I was a high school principal, I twisted my knee when running down a stair case. It was very painful in the knee cap area. I had mri done and it was reported that the anterior and posterior cruciate and medial and lateral collateral ligaments were in tact. However it noted mild heterogeneity of signal in distal fermur. In laymen's terms, what is that? How might this be related to my injury? My knee has continued to hurt me since that day I twisted it. What do you recommend I do? Thank You
Submitted: 1 year ago.
Category: Health
Expert:  Dr. Anil replied 1 year ago.

Hello,

Have you undergone repeat MRI recently?

Have you tried any medications,treatment so far?

Any other medical history?

Do you have swelling,redness,tenderness on affected area?

Do you feel pain at certain movements or continuous pain even at rest?

Are you overweight?

Thanks.

Waiting for your response.

Expert:  Dr. Arun Phophalia replied 1 year ago.

Hello,

Mild hetrogenecity in the distal femur is suggestive of knee osteoarthritis (age related or degenerative arthritis). An injury can either aggravate it or precipitate it. Following is the treatment:

1) Physical therapy; this is the mainstay of the management of the osteoarthritis. Stretching exercises, strengthening exercises, mild weight bearing exercises, swimming on the week-ends etc would be helpful.

2) Deep electrotherapy; this entails going to physical therapy center and take care of specific issues which are more painful.

3) Glucosamine and chondroitin supplements

4) Diacerin too can be tried which suppose to regenerate the cartilage.

5) Local analgesic sprays

6) Acupuncture

7) Consideration of hyaluronic acid injection in the joint. Some physician may inject steroid too for the pain relief.

8) Warm shower in morning would open up the joint.

9) Capsaicin (Zostrix, ArthriCare) is an irritant derived from chili peppers that provide relief by depleting a chemical that transmits pain from nerve endings. Various strengths are available without prescription. (It causes a burning sensation thus one has to be careful while applying and should wear a disposable plastic glove).

10) Acupuncture; most popular forms of alternative or complementary medicine, particularly for pain relief.

11) Analgesic patches too are available for the pain relief.

These are the exercise resources for the knee. You can pick the exercises which suits you;

http://bigkneepain.com/knee-exercises.html

http://www.pamf.org/sports/king/kneerehab.html

If overweight is an issue; long term is achieved by weight reduction. High impact exercises should be avoided; like kneeling and bending. These supplements help in rebuild the cartilage;

1) Omega-3 fatty acids, such as fish oil,
2) SAMe (s-adenosyl-L-methionine), 600 mg daily.
3) Glucosamine/chondroitin, 1,500 mg daily.
4) Bromelain, 250 mg twice a day.

Following homeopathic remedies are suppose to help;

1) Bryonia
2) Graphites

Following herbs are suppose to be good;

1) Ginger
2) Cat's claw
3) Willow bark
4) Turmeric
5) Devil's claw

To summarize: Following measures would be helpful in the knee arthritis;

1) Knee care in the activities of daily living. Few simple self-care measures can be remarkably effective in ending pain cycle.

a) Avoid prolonged standing or walking or sitting with joint in a single position.

b) whenever you sit, keep the knee stretched and fold them intermittently.

c) Squatting, sitting cross legged should not be done.

d) Avoid climbing stairs.

e) Avoid sitting legs unsupported or hanging.

f) Reduce weight if over weight/obese.

2) Rest: Taking a break from your normal activities reduces repetitive strain on your knee, gives the time to heal and helps prevent further damage.

3) Anti-inflammatory medications

4) Physical therapy; the goal of physical therapy is to strengthen the muscles around your knee and help you regain knee stability. Ideal is supervised physical therapy. Stretching exercises are also part of the physical therapy regime.

5) Orthotics and bracing.

Expert:  Dr. Arun Phophalia replied 1 year ago.

It is privilege assisting you.

Please let me know if you have further queries or unanswered questions.

Please consider a positive rating if this interaction has been satisfactory, as this is the only way we experts are credited and compensated for the time and work. You are not charged again for giving a rating.

Thank you.

Wishing you all the very best in life.