Knee swelling, no pain, no injury for four months now

Hello!
It's been four months now that my right knee is slightly swollen. The swelling is visible on the knee itself and the bottom part of my quadricep. It is not much but it's visible especially when compared with my other knee.

I don't feel pain, only minor discomfort which gets a bit worse and spreads to a larger area (the discomfort, not the swelling) when I stand up or sit down for too long. I can walk, run (I don't though), climb stairs and squat (I don't) without any problems.

This has been going on for the last 4 months without any improvement. I've visited two Orthopedists who pushed pulled and did various things to my knee which should have produced pain but didn't. My reflexes were also checked and are fine. I have rested my knee completely during the first 1.5-2 months after it started, and I have been a bit less conservative for the last two months. By less conservative I don't mean anything that would even qualify as light exercise.

I started doing 15 minute ice treatments since after 2 weeks the swelling appeared. I've used about 70g of JointCare cream from Seven seas, "for the symptomatic treatment of joint pains" throughout a couple of months, as per the instructions of the first Orthopedist. He told me that it's nothing and that I should just rest, do ice therapy and use the cream. So I did. I've stopped using the cream because it makes me feel less discomfort and I tend to spontaneously do movements that I shouldn't .

I've also been to a physiotherapist who also said I just need rest and ice treatment and nothing more. He told me that the patella probably got slightly out of its designated track momentarily and the joint got inflamed.

A month ago I went to another Orthopedist who prescribed 10 Mobic pills, one per day. He said he wouldn't prescribe them but the swelling shouldn't last for this long, so he did. They didn't seem to change anything. I visited again, he checked my knee again, made me do a couple of squats and seemed perplexed. He prescribed an MRI but he said that he only did that because he can't find anything else. He told me that it's "chronic tendinitis". I asked why it's "chronic" and he said that it's just the way it's called because it's not "acute".

Before this, I cycled a lot (almost daily), practised Aikido twice per week (strains the knees), practised a bit of Yoga once per week and practised my balance on a "slackline". I've stopped cycling since. I stopped Aikido for a couple of months and then I started practising lightly (no sitting on the knees, no knee-straining exercises). I've carefully practised yoga avoiding knee-straining exercises throughout the last four months (but I've stopped a couple of weeks now just to see if anything changes). I've stopped slackline balancing.
I'm 27 and don't have any serious health conditions or allergies. I haven't injured my knee at all, besides the usual stuff (such as rarely banging it on a furniture). I weighed around 76kg when this started, now I'm around 81kg due to the lack of exercise.

I believe that this whole thing started one night during Aikido practice. I was getting up from a roll and I felt slight pain behind the patella probably due to the unnatural knee angle and all my weight being on the right knee. I've had this happen to me before, but in the past I stopped practising immediately, I rested and was fine by the next day. This time around I continued practising for another 1 hour (without significant pain though). Next day I was in the park balancing on the slackline carefully, avoiding much weight or sudden drops on the right knee. By night, I could feel my right leg very tired and the knee was swollen. I believe this is when it started.

I'm curious as to why my knee hasn't healed since I've rested it for so long. I was told that it's tendinitis, but from what I'm reading tendinitis should have caused me pain.
I've included a photo of my knees. It's my right knee, left one in the photo.

I can't wait for my body to heal itself, because I've been away from the things I love doing, during the last 4 months. Any information, tips or suggestions?:)

[S. Kaul, MD]

Hi there!

Well, without a clinical evaluation it would be difficult to determine the cause of your discomfort. Likely possibilities that may need to be considered infections/ inflammations, bursitis, tendinopathy/ tendonitis, chondromalacia/ patellar dislocation, arthritis, cyst formation, growths etc. It would be inappropriate to suggest a management plan without knowing the exact cause of the symptoms. I would suggest consulting an orthopedician, preferably at a university or teaching hospital, for an evaluation. After a specific cause is identified, it can be managed accordingly. Meanwhile I would suggest relative rest and anti-inflammatory medications and see if these seem to help.
Hope this helps.

Take care!

[kritsku]

Thanks for your reply Dr.
I've been to two Orthopedists over the course of the last 4.5 months, and both of them had a look and pushed/pulled/rotated my knee. They both said that they can't detect anything and that I should just rest. The second one gave me Mobic pills, which didn't improve my condition. He said that he would characterize what I have as "chronic tendinitis". After that he recommended an MRI since he couldn't conclude why my knee hasn't healed yet.
I've also visited a physiotherapist who also recommended rest and ice therapy.
Note that I have rested well for the first two months. Also note that there is no pain involved. I just feel the swelling, a mild discomfort.
I understand that it's dangerous and difficult to diagnose from half a planet across. I'm just looking to narrow down what might be wrong with my knee. I need help to understand why it hasn't healed yet.
Again, thank you very much.
Have a nice day,
Kritsku