pain in leg

I had some mild pain in the calf of my left leg.  My doctor said it is not a clot.  The pain has gotten extensively worse now affecting the knee.  I went back to doctor and the doctor said it is arthritis of the knee and that, at this point, no tests were necessary.  Well, in spite of anti-inflammatory meds, I cannot put my full weight down on my leg without pain that seems more concentrated directly under the knee. I am walking around limping.

I am afraid that if something else is going on, I may be injuring it more by walking on it.

Can you answer the following for me?

1.  Should I be getting x-rays or a MRI?
2.  Can I be causing more harm by walking around with this pain?
3.  I have been on anti-inflammatory meds 3 days now and feels exactly the same, is this normal?

I am a 55-year old female who, up to now, has had ocasionally achiness in lower back and legs.

Thank you for your time.

[J.M. Keyes, MD]

Hi there,

Physical exam of the knee is a big part of diagnosis, so unfortunately I won't be able to give you a definitive answer as to what is going on.  From what you tell me though, I certainly think that further testing is warranted, since your pain seems to be relatively severe.  It is possible that you are having a flare of arthritis, but it could also be something like a meniscal tear.

If you are still having calf pain, that should be addressed again, especially if you are having any swelling or redness of the calf with it.  Blood clots in the leg can be quite dangerous, as they may migrate to the lungs.  If this is still an issue, please talk to your doctor about further testing for that.

Assuming the calf is resolved, and your pain is now isolated to the knee, I think you should at least be having xrays.  If these show that you have no arthritis, an MRI may be a good next step to assess cartilage/meniscal/ligament damage (again, physical exam would help your doctor have an idea if one of these was likely, but this isn't always reliable) .  If you are having any clicking, locking, or giving way of the knee, you should probably have an MRI and see an orthopedic surgeon.

If when you say "under the knee", you mean at the back of your leg, rather than under your knee cap, another possibility is a ruptured Baker's cyst- a Baker's cyst is caused by knee joint fluid protruding to the back of the knee, and can cause pain.  This can usually be diagnosed by ultrasound.

It's unlikely that you are doing much damage by walking on the leg, but if you in enough pain that you are limping, you should take it easy, and use a cane if need be until things settle down.  You should also ice your knee regularly, and stay on your anti-inflammatories until you talk to your doctor about coming off of them.  Generally you would see some relief by now- if you still have none after a week, your doctor may be able to switch you to a different anti-inflammatory to see if it helps better.

I hope this gets resolved quickly for you- it sounds like it is really affecting your quality of life right now.

Best of luck.
JMK MD

[gad227]

Thank you so much for such an in depth explanation.  I asked my doctor today to give me a referral to an orthopedic and will see him on Wednesday as the pain is very bad with any kind of activity.

Thanks again.