Knee swelling diagnosis

[fjix]

Hello.  I have had problems with my left knee on and off for several years, but never got it checked out until just recently, when the swelling became overwhelming and I could barely bend it or walk.

I went to an orthopedic doctor, and X-Rays showed no signs of arthritis, then he drained the fluid from my knee which looked clear with a yellowish tint.  He said that it looked normal, and that cloudiness, and blood are visual indicators of trouble.  I had those samples sent in to check for crystals, blood count, and some other odds and ends.  I also had an MRI done, and he said that the MRI is absolutely normal.  Before the MRI and lab results came in, we were operating under the "assumption" we were looking at a damaged miniscus (sp?)  But MRI normal and lab results negative for crystals, (no gout or pseudogout,) but showed elevated white count (2400) He said normal is 0-200, but that severe pathology can be as high as 30,000 or more.  I'm going in for blood tests, as he is now sure that this is not an injury.  I asked what we're looking for and what the worst case scenario he expects, and he said Lyme Disease, Rheumatoid Arthritis and Lupus were the top of the worst case list.  My dog has Lyme Disease and we live in a high risk area (Maryland,) so I wouldn't be surprised if the same ticks that hit her somehow hit me.

Anyway, hearing Lupus, really scared the bejeepers out of me, and now I have to play the waiting game, so I just wanted to get some professional opinions so I can calm my wild imagination.  

I am a 36 year old caucasion male and I don't really have any other joint problems to speak of.  The other knee is just fine, my hands are fine, shoulders, elbows, hips, all pretty good.  I do suffer anxiety and depression which I understand can be a by-product of a whole host of other conditions.

I suppose what I'm wondering is

1. Should I ask another doctor to look at the MRI films to get a second opinion (maybe he missed something?)
2. Are there "more likely" pathologies and "less likely" ones in the list of non-injuries joing swelling?
3. How bad are those top three?  I always thought Lupus was a debilitating and fatal condition like MS.  Am I wrong about that one?

Thank you very much for your time.

[fjix]

Thank you very much for taking the time to give me your input.  My mind is much more at ease.  I'm going in for the blood work today, and I'll check for an expert radiologist to look at my films.

This is really a fantastic resource, and I feel very lucky to have been given professional advice for FREE by just asking for help.

I sincerely appreciate you taking the time to chat with me.

Best Regards!

[Dr Vinod]

Yes a Radiodiagosis expert is a MD Radiology. You have to take an expert opinion and it may be Psoriatic arthritis, you never know.
Some amount of meniscal abnormalities are seen in some cases, need to know if they are really bad, confirmation can be given by the MD Radiology. All tears and injuries might not need operations.

With no other symptoms and only a history of Psoraisis, you go in the line of Psoriatic arthritis, mild arthritis, past knee injury etc till diagnosed.

Take care!

[fjix]

Thank you for your quick response!  I am a hypochondriac (part of the depression/anxiety,) and so I'm naturally afraid of hearing scary diseases....

Anyway, I don't really have any other symptoms that are reflective of these bigger conditions.

The tech that ran the MRI told me she saw abnormalities in the Miniscus, but added that she wasn't supposed to offer opinion or even show me the screens, so I was surprised that the doctor said normal.

No skin lesions, but I DO have Psoriasis which flared up last year briefly and went away just as fast.  But I remember reading the pamphlet about Psoriatic Arthritis that can occur with the skin issues.  Not really sure what a nodule is per se, but I don't think I've got them.

Is there such a thing as an "expert radiologist" that I can consult to give an unbiased reading of the films?  or does it need to be an MD?

Thanks again.

[Dr Vinod]

1)MRI images are the result of a machine and mostly there is nothing to do with the skill of the doctor, the Radiologist impression and comments are important, you can discuss your film near an expert radiologist for a second opinion.
2) Mild infection, inflammation also increases your White blood cell count. There is no need to come to a diagnosis and get scared of big diseases till diagnosed. The diseases you mention are all rare and check your genetic history to get pacified. You can get yourself evaluated for Rheumatoid factor.
3) Lyme's is an infection, Lupus is a systemic disease and it has plethora of symptoms in this case you do not have any other symptoms other than the joint thing, and the same is the case of Rheumatoid arthritis, what are your other symptoms? any skin lesions, nodules, etc. Do not feel anxious and wait for a diagnosis.
Take care!