Arthrritis the main culprit now?

[karenwilke]

3/16/03, tib plateau fracture(completly sheared off platuea & weight bearing surface was in pieces.  3/17/03 Plate & 13 screws, also anterior & lateral compartment syndrome(calf) released.  ACL reattached and meniscus completly torn lose & had to be removed.  12 wks non-weight bearing, 8 wks no ROM. Foot drop & AFO as result.  Dr said I would develop severe arthritis from the injury. 7/17/03, closed manipulation. While in recovery room was in severe pain crying & thrashing about & anestesia nurse came & gave me a femoral nerve block and felt like someone grinding my pelvic bone away.  3/16/04 still lots of pain, 40 degree rom, can't step up & had an EMG. Conclusion: 1.Left peroneal nerve palsy-axonal loss type 2. Posterior tibial branch nerve involvement cannot be ruled out but no obvious denervation  3. left femoral neuropathy-demyelinative type. Assessment: Muscles innervated by the peroneal nerve show significant denervation w/ positive waves and fibrillations.  Muscles innervated by the posterior tibial nerve reveal down number motor unit potential firing pattern which is probably neurogenic based.  This is also true in muscles innervated by the femoral nerve.  >Result: Physical therapist signed off on me, said nothing was gonna get better. Orthopedic surgeon said nothing he could do for me, prescribed a KAFO(oh what fun) and told me to see pain mgmt doctor.  Didn't like pain mgmt doc cause he wanted me to take 6 different meds & I slept all but 3-4 hrs a day.  Seeing a new pain mgmt doc this Friday.  Pain just setting down, but when I walk I have terrible pain in my knee, hurts when sheet touches it.  Back of knee(bend) hurts worse to the touch than the front.  Do you think that most of my pain is being caused from my "neuropathies", or do you think that it could be this severe post-traumatic arthritis the original surgeoun warned me about.  Trying to figure out where to go from here.  What is post traumatic arthritis??

[Kevin Pho, MD]

A definition of post-traumatic arthritis can be found here:
http://www.vermontorthoclinic.org/arthritis/pta.html

Although, I am not aware of the symptoms you are describing being consistent with arthritis.  The EMG confirmed that the pain may be neurogenic in origin.

Before consider a pain management specialist (where the pain is treated, not the underlying causes), you can consider a referral to a neurologist to see if there is anything that can be done to treat the source of the pain.

If this referral is non-revealing, then pain management or a physiatry referral (rehabilitation specialist) would be the next appropriate step.  

These options can be discussed with your personal physician.
Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
http://www.straightfromthedoc.com

[karenwilke]

Thanks for the comment.  I went to see this pain mgmt doc and he ordered new x-rays and a triple phase bone scan.  I got those done earlier this week and look forward to next doctor's visit.  I was pleasantly surprised to hear that this pain mgmt doctor wanted to find out the exact cause before doing anything.  He is looking at possibly RSD/Complex Regional Pain Syndrome.

[shaikhmohdmusa1]

My friend is sufferings from rhmatoid arthritis factor,in her blood ,she frenquently go for her shoulder theraphy ,to ease  her constant pains,she have no idea what type pain relief to take other than tylonal,which she claims doesnt lasts long..Any pure suggestion appreciated.Thankyouverymuch