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Ask Dr S.A.Alam Your Own Question
Dr  S.A.Alam
Dr S.A.Alam, Doctor
Category: Medical
Satisfied Customers: 4468
Experience:  MBBS/FCPS(R)/MRCP(R) U.K
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I am a year old female and 2 months ago I wakened up one

Resolved Question:

I am a 69 year old female and 2 months ago I wakened up one morning with pain in both of my knees. The problem is made worse when I walk as I get a burning pain with some fliud around my knees. Ice seems to help the burning. My knees have been x rayed but nothing showed up. I have been told I do not have athritis, gout,infection, a virus or renal bone desease I have polyscystic kidney desease and have been on haemo dyalysis three times a week for 4 years. Prior to my knee problem I was very active mainly going walking everyday and now I cannot walk without discomfort. At present I am waiting to have a MRI scan and I just recently tried Gabapentin to see if this would help the pain but so far it has not helped. Also tried ibprofen with no luck
Submitted: 2 years ago.
Category: Medical
Expert:  Dr S.A.Alam replied 2 years ago.
Dr S.A.Alam :

Hello, Welcome to JustAnswer and thank you for your question.

Dr S.A.Alam :

Is there redness ? swelling over the knees ?

Dr S.A.Alam :

Does it hurts when you press the knees ?

Dr S.A.Alam :

Does the knees feel hot when you touch them ?

Dr S.A.Alam :

Do you have fever ?

Customer:

There is no redness or pain pressing my knees . There is a little swelling which looks like fluid. I do not have any fever

Dr S.A.Alam :

In most cases this settles but if there is pain, fever, redness or swelling... any one of these symptoms is an indication for joint fluid testing to make sure it is not infection.

Dr S.A.Alam :

So my advise is to see your medical doctor as he needs to tap the joint fluid to make sure it is not infection.

Dr S.A.Alam :

You have questions ?

Dr S.A.Alam :

This is not arthritis because all your tests for arthritis are negative.

Customer:

I have been searching on the internet and I know doctors don,t always like patients to suggest things but I found info on a condition called pseudogout could this be what I have.

Customer:

I have been told I do not have athritis as nothing showed on my x ray

Dr S.A.Alam :

If this was pseudogout then your knee tests like X rays and MRI if done will pick abnormalities.

Dr S.A.Alam :

like crystals and joint damage.

Dr S.A.Alam :

If your diagnosis of absence of arthritis was made only on X rays then it can be an option.

Dr S.A.Alam :

As you mentioned that there is no redness and tenderness

Dr S.A.Alam :

so this also goes against pseudogout.

Dr S.A.Alam :

because in these cases joints are extremely painful and tender

Dr S.A.Alam :

and red.

Customer:

I did ask about having fluid taken when I was at a&e but the doctor said she did,nt think there was enough fluid to do it but some days there is more fluid than other days so maybe it could be done then

Dr S.A.Alam :

Joint fluid aspiration is must in your case because it will rule out infection, arthritis and gout.

Dr S.A.Alam :

Yes it is common for the fluid levels to vary with time because amount of inflammation varies with time

Dr S.A.Alam :

Taking out fluid is best option to make clear diagnosis.

Dr S.A.Alam :

You have questions ?

Customer:

At the moment my gp has not refered me to any consultant and I was wondering what would be the best type of consultant to see

Dr S.A.Alam :

Rheumatologist is best for this problem.

Dr S.A.Alam :

You have questions ?

Dr S.A.Alam :

I hope chat is helping ?

Customer:

I also would like to ask could this condition be caused by a lack of vitimin D. I have asked my Renal consultant if she thought I had some kind of bone desease caused by my kidney problem but she assured me that my blood results did not show this

Dr S.A.Alam :

In case if low vitamin D levels long bones are more effected before joints

Dr S.A.Alam :

they get weak and prone to fracture.

Dr S.A.Alam :

In my opinion this is knee joint effusion caused by your dialysis, and infection needs to be rule out with joint fluid test.

Dr S.A.Alam :

You have questions ?4

Dr S.A.Alam :

Let me know if you have questions, ?

Customer:

Yes it is helping me to chat with you. I think I will ask my GP to refer me to a Rheumatologist and get some tests done to find out what the problem is. Thank you for answering all my questions I now have a better idea of what I need to do Irene

Dr S.A.Alam :

You are welcome, irene.

Dr S.A.Alam :

Have a nice day and do rate my answer thank you.

Dr S.A.Alam :

Take care.

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