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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Severe Pain In The Right Knee?

Hello -- about a month ago, the onset of severe right knee pain began. Dr., I found that to be odd because my pain is primarily in my Lumbar and Iliac region. Until recently, I have not experienced pain other than that pain associated with DDD. Nonetheless, the knee pain is a sharp, stabbing pain brought on while attempting to stand/walk. I am overweight/obese (5 8 / 209 lbs), 58 yrs old, history of restaurant employment (which required me to be on my feet ~12 hrs/day). Multiple incidents of falls (due to using roller blades when they were en vogue: 1990 s LoL Ouch) + High impact jogging/running (to keep weight down) + 22 yrs. mixed/combined martial arts (including TaeKwonDo/Aikido/Jujitsu). Further, as mentioned above, I have severe DDD w/heavy remodeling on L2-L5 & curiously also found in C-spine. Along with all of that, & to address my acute right knee pain I did go to ER. Xray s show that I have no cartilage...whatsoever, on my right knee. ROM is limited. The ER MD highly suspects a partial tear on the lateral right knee ligament. Due to DDD I am seeing a pain management MD. To manage the level 8 to 9 pain daily from DDD & other (soft tissue, etc) pain associated with DDD, I am Rx d 15mg Morphine / 3x daily + 100mg Gabapentin 3x/day & 2mg Tizanadine @ bedtime. Incidentally, the combination of meds are effective. So, when pain medication abates (eg break thru pain) somewhat -- the knee pain is the 1st mega-pain sensation to emerge until next scheduled dose is in effect. I am now seeking advice & counsel from an online and unknown resource because the Pain Management MD has still not given me a direct answer or even a sufficient guess as to the diagnosis of my knee and the medical protocol to employ to correct it or live with it. Because I am now experiencing extreme right knee pain, along with edema & NOW, AN UNUSUAL BULGE/LUMP/MASS/BUMP on the right side of my knee--seemingly seated just on top of the injured ligament. As I mention, I did see an ER doctor who did confirm that I am experiencing effects from a torn (perhaps not completely torn, yet) ligament. The Pain Management MD has an insufficient bedside manner and has seemingly ignored my knee issue. I will /I am seeking alternate Pain Management personnel at this time. In the meanwhile, this bulge, bump, lump or mass is troubling. In fact, during that short period of time when I do experience break-thru pain, it is because a strangling or tightly squeezing sensation overtakes my knee area. The pain from this is troubling. For over 7 generations, those who share the paternal bloodline in our family have had Factor V / blood clotting issues. Due to this new squeezing sensation in my right knee (the tissue found behind the knee vs the structure of the knee) I felt a bit of a panic or fear: “Could this be a blood clot?” I took two regular Bayer aspirin this AM as a precaution. Thank you for tolerating my over explanation of this issue. Sir? What is this lump / bulge on my right knee???? With gratitude, I will await your response.
Mon, 20 Nov 2017
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Anesthesiologist 's  Response
hi sir,really you are so responsible and sensible to give such an elaborative history that really eases our work.as you mentioned a family history of factor v deficiency,we can put hemarthrosis or joint bleed in differential diagnosis.knee ligament tears also mimic the same.i usually advise my patients to undergo arthroscopy that confirms the diagnosis.please do not neglect.any more queries,i'm ready to take up.thank you.take care.bye.
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What Causes Severe Pain In The Right Knee?

hi sir,really you are so responsible and sensible to give such an elaborative history that really eases our work.as you mentioned a family history of factor v deficiency,we can put hemarthrosis or joint bleed in differential diagnosis.knee ligament tears also mimic the same.i usually advise my patients to undergo arthroscopy that confirms the diagnosis.please do not neglect.any more queries,i m ready to take up.thank you.take care.bye.