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Rheumatoid or Osteoarthritis in a 22 year old?

Hey guys, I have just started visiting this forum and it is so helpful and informative. I do have a question and just want some of your opinions on what my diagnosis could be.
So ever since I was probably 14, my right knee would occasionally lock on me to where I couldn't straighten my leg without severe pain. To fix this I would always have to push through the pain and straighten my leg all the way and it would make a loud pop noise and be fine but extremely sore.
As I got older, this started happening more and more and being more painful. Then, my knees would just ache pretty much chronically.
Finally, I visited an orthopedic surgeon as suggested by my wonderful PCP. We did an X-Ray, MRI, and blood work. X ray showed some damage but nothing significant. I have never had any trauma to my knees by the way.
The MRI showed that I didn't have much cartilage in my right knee. Blood work came back negative for possible diagnoses like Rheumatoid Arthritis (RF level was normal).
So, the surgeon suggested that since I was having such difficulty with the locking and general pain in my knee that we do an arthroscopy on my right knee. I said yes hoping for relief after all these years.
The weeks leading up to the surgery he prescribed me Lortab 5-500 (when they still made this strength) 1 every 4-6 hours and would always make me call his nurse to get a refill which was a little annoying but that's fine.
Anyway, go through the surgery where he cuts some stuff that he thought might be making my knee catch and think I am good to go. He showed me pictures he took while in my knee and said I had some mild arthritis on it which somewhat worried me but he said it didn't seem concerning.
I was great for a few weeks then the locking and general pain came back. Not as often as it used to but still painful and such. Also, now my left knee which used to rarely ever lock or hurt is now doing both. They lock on me and just in general hurt.
So I went back to my surgeon and he got another X ray which didnt show anything that different and ordered blood work and a MRI which we are going to look at at my next appointment. He thinks my arthritis might be progressing but honestly he says he really doesn't know what is going on as every other patient he has done arthoscopies on have never had trouble again. He said if my MRI and blood work come back inconclusive and he still is stuck he will refer me to a rhematologist which scares me.
For some background I am a 3rd year pharmacy student and know what the surgeon is saying as I have learned about all of this stuff in school. So, I suspect that I don't have RA and maybe it is just osteoarthritis albeit at a very young age. However, RA is a tricky disease and it could be a possibility.
I just want to hear y'alls' (that certainly gives away what region I am from ha) opinions on my situation just to get some feedback.
Also, at my last visit he didn't prescribe me any pain meds which was kind of confusing but I know doctors are wary of their prescribing habits and such but I left a message with his nurse later that day asking for something (anything) for the pain as it was definitely holding me back. I thought he would want to wait until he saw my bloodwork and MRI but surprisingly he called me in some Norco 5-325. It seems to work well and I don't have to take it at the max dose each day. I just don't think he will continually prescribe me this if he finds out what it is or if he doesn't. I have never been to a rheumatologist but I don't think they would prescribe me chronic Norco for my knee pain. So I am also just concerned about how my pain is going to be controlled in the future.
So sorry for the long post but I just wanted some other peoples' input on my situation.
1 Responses
1193998 tn?1265121197
Hi there,

Don't be afraid of the rheumie, he or she won't bite. (kidding!)  The rheumatologist knows what to look for better than a PCP when it comes to autoimmune disease, and ruling it out. Blood tests never tell the whole story, so he will probably also get another set of xrays, and most importantly, lay hands and eyes on every one of your joints. That first appointment may seem a bit laborious, but hang in there. :)

As you know, autoimmune disease can be tricky, and manifests differently in every person. Your left knee is probably giving you problems because since the surgery, it's been doing most of the work of weight bearing, balancing, etc.

It could be you have a minor birth defect that affects the mechanics of your knees. Has anyone sent you to a physical therapist? Maybe someone who specializes in sports medicine could help.

It never hurts to get a second or even third opinion. Don't give up!
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