Fever is not necessarily co-incident with many low-grade infections. So infection is unlikely, but not ruled out.
Culture of the fluid extracted would be a good first step.
An x-ray is a good idea, but an MRI of the knee is better. I would also ask for an MRI of the foot.
And I would not necessarily head for the conclusion that a total knee replacement is necessary.
I am concerned about the constellation of symptoms, particuliarly the pain in the ankles and forefoot. Arthritic pain is not relieved by extraction of fluid.
The comment "treated for crack in skin" and "infection" intrigued me.
We have swelling in several areas, and the pain, in such instances, is generally caused by such swelling impinging on nerves.
My question is what kind of fluid is building up?
I think you should get a tuberculosis test. While TB is typically associated with the lung, you can get these infections anywhere.
Infections in the legs can become encapsulated and become difficult to get rid of because oral antibiotics do not travel well to the lower extremities.
Pain in the ankle and forefoot of one leg is not typical of systemic arthritis. These are focal findings.
The numbness is another issue that concerns me.
A question you should ask your physician is "why is there numbness".
I would also get a vascular consult and a doppler of both legs.
As Dr, Nooper stated minescal injury and nerve compression come to mind as a first guess.
There are a lot of missing pieces here.
hello munish,
one good this which i noticed in this posting is that, you have not mentioned anything related to fever. SO infection is ruled out.
Her age and a history of injury points towards reactive arthritis secondary to osteoarthritis. The best treatment, presently for Osteoarthritis , is Total knee replacement.Can you upload her knee X-rays on the photo section, so that i will be able to comment on that.
any querries, do ask me,
regards
abhijeet
Hi,
Thanks for posting.
It is important to know what the findings of the X ray were. Also at this point a repeat X ray of both the knees and an orthopedic evaluation is warranted.
There can be many causes of knee pain like arthritis, bursitis, meniscal injury, and tendinitis and nerve compression.
I will urge you to get her orthopedic evaluation done at your earliest.