How are you feeling?
When any patient complains of “knee pain,” the initial differential diagnosis in most of the cases includes: Osteoarthritis, Ligament damage, Meniscus damage or Patello-femoral disorder.
Your symptom of pain at the joint line is the result of a collateral ligament or meniscus problem (or both) until proven otherwise.
When did your pain begin, what were you doing at the time, and what were the initial symptoms?
Your other symptom of feeling of grinding and grating is characteristic of osteoarthritis.
What is the quality of your pain (sharp, shooting, dull, etc.)?
Have you tried anything to help the pain and, if yes, has that been successful?
I think your symptoms are suggestive of osteo-arthritis. You can plan for additional diagnostic evaluation: X-rays, including AP, lateral, sunrise, and postero-anterior views with the knee flexed to 45°, should be obtained. Treatment options include conservative care, including rest, weight loss (when appropriate), physical therapy—including nonimpact exercises, such as swimming—acetaminophen, NSAIDs, heat modalities, activity modification, ambulatory aids, such as a cane, should be used.
Topical analgesic therapy with methylsalicylate or capsaicin cream may be beneficial. Oral glucosamine sulfate (1500 mg) and chondroitin sulfate (1200 mg) taken daily are also helpful.
Intra-articular injections of hyaluronic acid improve symptoms temporarily but typically need to be repeated periodically (about once every 6 months). Intra-articular injections of corticosteroid and anesthetic may also be helpful.
Surgical options are reserved for persistent or severe symptoms and include arthroscopy, osteotomy, and total knee replacement.
Keep me informed if you have any queries.
Thanks for ur concern.
I'll clarify some of the questions tt u raised.
Firstly, my knee pain came about because of repetitve stresses to my knees. I was standing for prolonged periods when the pain escalated. Prior to tt, my knee received a blow to the side when playing soccer. The initial symptoms were pain at and below the patella. I could not walk properly for almost 3 months. I persisted to have Bilateral Knee pain, however my Orthopaedic felt it was nothing really much and did not see the need to probe further which I thought was utter nonsense.
I've also had a blood test taken to determine if Osteoarthritis was the cause. However, the test turned out negative for Osteoarthritis. I had an X ray done as well which did not reveal anything significant. However, the Orthopaedic did an Ultrasound and found tt it was Patella Tedonosis which I did not think was the case. In fact, another Orthopaedic (private) diagnosed me as having CMP with bilateral knee effusion.
What do u make of both diagnosis? Which is more accurate? Or do u think I shld go for an MRI scan?
Thanks and regards.
I always feel nice when a patient is discussing about his diagnosis. Well to go with first diagnosis that is Patella Tendonosis.
It is a disabling condition which frequently affects sportspeople (which I assume you are having), mainly jumping sports (like football) with insidious onset of pain localized to the area just under the kneecap (which is also your symptom).
Do you feel painful when walking or running up slopes, or getting up from sitting?
Are there any positions that make your knee more or less comfortable?
If answer is yes for any of the question then it would be Patellar Tendinosis.
If otherwise it would be Chondromalacia Patellae, but I would root more for Patellar Tendinosis.
I think I would recommend going in for a MRI study.
Keep me informed if you have any queries.
well I was diagnosed with chondromalacia and have already had 2 surgeries on the same knee and have problems with the other one too. I had a chondroplast and the doctor told me it was third degree and smoothed it out. My second surgery was another chondroplasty with a lateral release. I have certain relief but im scared that if I go back to school it will get bad again what due you recommend? I feel very limited and im only a teen it all started after several dislocations and my patella is slightly tilted.