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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
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Experience:  Over 20 yrs of Family Practice
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I have severe right knee pain and have had it for MANY

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I have severe right knee pain and have had it for MANY years. It wakes me up at night, many times, because it hurts. It pops, grinds, gives out on me and fall down stairs or wherever I happen to be. It is getting more and more painful by the day and is becoming less and less steady on my feet because of it feeling like it's going to give out. Sometimes I can't even bend my knee. I had an MRI of the right knee and this is the report.
What do these things mean:
1) There are findings suggesting a subtle horizontal tear extending through the posterior horn media meniscus to the inferior articular surface. This is only demonstrated on 1 image and clinical correlation is recommended for meniscal symtomatology as the rest of the meniscus appears normal.
2) Slight increased signal and thickening of the anterior cruciate ligament as it extends towards the femoral attachment. The findings are felt to represent a mild strain or old injury to the ACL without findings of acute disruption. Clinical correlation recommended. Ligamentous structures otherwise appear normal.
3) Mild joint effusion.
4) Mild soft tissue edema extends along the inferior medial soft tissues in the patella consistent with inflammation without definite bursitis.
5) Minimal grade 1 chondromalacia patella the junction of the medial facet and median ridge. The osseous and cartilaginous structures are otherwise normal.
Hi--can I first ask if you have any problems with any other joints and have you been screened for autoimmune disorders like rheumatoid arthritis?
Customer: replied 4 years ago.

I have been screened for RA and been told I don't have it yet by one Rheumatologist and then told I do have it by another. I have been diagnosed with Fibromyalgia and I have chronic Lyme disease. Chronic fatigue syndrome. I am overweight.
I did get into a car accident in 1998 where I was rear ended. The car that hit me was doing about 35-40 mph and I was stopped at a red light. The knee pain has been off and on since I was a teenager though. I would just be walking and bam, on the ground because my knee just gave out. The past 3-4 years though my joint and back, hip, neck pain has increased at a very rapid pace.

I was perfectly healthy 4 1/2 years ago other than the knee pain on occasion and daily migraines. I became pregnant. at 6 months I developed preclampsia. I was in and out of the hospital because my BP would sky rocket and protein in the urine, etc. At one point I was so low on potassium they put me in the hospital and gave me potassium via IV (let me say, that was severe pain!). I went home that night, woke up around 4 am, couldn't say two words without gasping for air. I went to the ER and I had pulmonary edema. I was drowning in my own fluids. They immediately put me on Lasix. I peed 11/2 liters of fluid in 45 minutes. They then induced me. Told me I would die if they did a c-section because I was already dying from the edema. It had flooded my entire body. I gained 17 pounds overnight. I was induced for 4 days, finally had the baby and I hemorrhaged almost died again. Very, very bad experience. Baby was fine but 2 months premature.

I had some BP issues for a few months afterward but then something happened to my body. I started getting fatigue, severe fatigue. I would sleep for 18 hours straight. I had no energy. My entire body hurt like I was being stabbed with knives. My joints hurt, my hair hurt. EVERYTHING hurt. Many, many, many test and doctors later they decided I had RA and Fibro. Then about 2 years ago I bit by a tick and tested postive for Lyme disease. They didn't treat it properly and it became chronic. Now I am on a 400mg Doxyxycline dose daily for going on a year. And the joint, back, neck pain is extreme. I cannot even sweep my floor without being in agony. When I walk I hobble like a penguin because my low back, hips and knees hurt so much...

I was perfectly healthy prior to the birth of my daughter. Now I have all this going on. I feel as though my body is rapidly aging. Oh... I also have severe adrenal fatigue I think is what it's called, I'm going into menopause at 39, my thyroid just went out of whack too. I have too much reverse T3 so they are pumping me with T3 to try to make the receptors fill with that instead of the reverse T3.

Something happened to me with that traumatic pregnancy. Something has turned my body against itself or something. I don't know what's happening to me.. I don't know what to do. I also have an MRI of my Lumbar spine next week and xrays of my hips.

Customer: replied 4 years ago.

Oh, I also never played any sports. I only did cheer leading at Elementary school for 2 years so no real jumping around and gymnastic type stuff the older schools do.

OK--thanks for the information. Has a specialist examined your knee and seen the MR results?
Customer: replied 4 years ago.

My PCP saw it and referred me to an Orthopedic Surgeon. I just don't understand what it all means. Will I always hurt. Is it fixable? If so, is it surgery?

OK--and we can continue after this if you'd like. The MRI report shows a tear in the meniscus--the cartilage that cushions the inside of the knee, an bit of tendinosis or scarring of the ACL which is one of the stabilizing ligaments of the knee, some fluid buildup from inflammation, and a small amount of disintegration of the cartilage behind the kneecap. The interesting part is that none of this should be giving you the extensive problems you're having with the knee and that's why I asked about the autoimmune screening. I think the real problem is indeed rheumatoid arthritis although the torn meniscus could be part of the symptom complex. I think you need another rheumatologist opinion and more testing and treatment for RA as well as the orthopedist's opinion on whether the meniscal tear needs surgery.
Customer: replied 4 years ago.

I understood that RA was double sided meaning it has to be bilateral.. While the other knee does have some pain, it's nothing like my right. Could it still be RA then?

I contacted my PCP and requested the left knee to get an MRI as well. He has ordered it and I will get that done next week I imagine.

Sorry for the delay. No, RA doesn't have to be bilateral. Let me know how it goes but remember to rate my answer please
Dr. Chip and 3 other Health Specialists are ready to help you
Customer: replied 4 years ago.

Can I keep you updated on this thread?

Customer: replied 4 years ago.

Oh and thank you so very much for your help. I really appreciate it sir.

~ Gina

My pleasure, Gina--any time
Customer: replied 4 years ago.

Do I have to pay $17 everyone you respond? I keep seeing the rate thing but I already rated you excellent plus a tip.

Customer: replied 4 years ago.

Do I have to pay $17 every time you respond? I keep seeing the rate thing but I already rated you excellent plus a tip.

Also do I keep replying here to keep you updated?

Sorry for the delay--the payment is only made each time you rate an answer of mine. As for keeping me informed, it would be best to do that on a new question page