Knee Injury after a Fall (bursitis?)

[Amberinpain]

Hi, I injured my knee (by falling) a few months ago. X-rays show nothing damaged. Just above my knee, it's swollen still. I've been taking naproxen sodium for 7 days and not seeing any improvement. In fact my knee feels worse, like the muscles are tightening around the knee and hurting it. It's like a burning pain and is making daily activities harder to accomplish.

I'm resting as much as possible and stopped weight training for my legs, as per doctor's orders. Is there anything else I can do to help my knee heal? My doctor told me if the swelling doesn't go away in 10 days of taking the naproxen that I'd have to go to physical therapy. But then I read that PT is not good when inflammation is still present. Also my doctor won't drain the bursa because he says it's too much of a risk for infection. Is this true?

Thanks for any advice given. I appreciate it!

[lmmmm]

Back in March I had a moped injury; went to emergency; ER doctor did not get close to leg or touch it, just ordered me to PT to be fitted with a brace, ankle to upper thigh and come back in 3 wks if not better? Needless to say before leaving PT I could not use the crutches with the stiff brace so offered a walker and a smaller brace that went above the knee and below the knee with a cut out for the knee.  I wore that and stayed off of it as much as possible.  Constant pain, heavy Naproxen.  3 wks I went back...primary doctor ordered an xray/mri which I had to wait 2 wks before but did prescribe me Vicotone instead of Naproxen.  In 2 wks I walked stiffly in with brace to the xray/mri and had that done.  When I went to get off the table they said I was not to WALK on the leg and ordered a wheel chair?  Then a run-a-round from emergency room, to another clinic where I was told I had a fracture and would be set up to see a bone doctor and physical therapy?  Two weeks later I saw the bone doctor's nurse (same day I was scheduled for pt) who then informed me I had a compressed fracture of the tibia outside??? To continue being off my foot and come back in 3 wks to be rexrayed-see bone doctor and physical therapy.  MEANWHILE, my whole knee all around is swollen, heavily inflammed still.  I am afraid surgery may be indicated and need some feedback from someone.  I go back this Friday.

[Amberinpain]

I saw my family doctor. I have an HMO and have to get his approval for a specialist, and he says a specialist will have me doing the same thing (meds and PT). I don't whether to just go through with the PT and hope for the best or to get a second opinion from another family doctor (which will be awkward since I'd have to get written approval first from my doctor). I figure the insurance company frowns on MRIs and that's probably why my doctor is holding off, but after 3 months with this injury I think it'd be useful to get one. Years ago, my husband was given the runaround for his knee injury...2 years later, after a hellish nightmare with the doctors and insurance, he finally got approval for an MRI and they found out he needed arthroscopic surgery. He is 100% better today, thanks to that surgery (and his persistence).

[sara_eagle]

Did you go to your family dr or did you see an orthopedic surgeon?

[Amberinpain]

Thank you so much for your reply! NSAIDS and RICE haven't helped my knee (so far). I'm on my feet most of the day (I'm a mom of young kids), so that's probably working against the healing process. However, I do notice when I exercise at a low intensity on the elliptical, my knee feels better for a while. When I rest my knee, it gets stiff and painful.

I'm surprised my doctor doesn't want to do an MRI. And when I asked for a referral to an orthopedician, my doctor said no because a specialist would just send me to physical therapy. I'm feeling let down by my doctor and am thinking I need a second opinion (if my HMO allows it).

Thanks again for the information!

[S. Kaul, MD]

Hi there!

Well, usually for knee injuries an MRI is advised as well, to rule out ligamental, meniscal and cartilage injuries that may not be visible on X-rays. The swelling above the knee could be due to cyst formation/ bursitis, which usually depicts an underlying problem like an underlying injury/ inflammation. It would be best to get this evaluated by an orthopedician for appropriate diagnosis and management. If the injuries have been ruled out and indeed it is just plain bursitis, a surgical drainage is not advised since these tend to heal well with conservative therapy; besides it may tend to be associated with a high risk of complications like infection. Meanwhile your may try resting and immobilizing the knee and avoid putting any kind of pressure or strain on it. Ice packs may help reduce the swelling. For pain you may try some tylenol/ NSAIDS to reduce the inflammation.
Hope this helps.

Take care!