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Suggest Treatment For Osteoarthritis In Left Knee

Posted on Wed, 18 Feb 2015

Question: This question is for a Rhuematologist. I am a 50 year old female. In 2012, I started having pain in my left knee. My PCP did an MRI and it shows that I have osteoarthritis in left knee. A few months later, I noticed a severe burning sensation that felt as if it was in the vein of my right arm (elbow area). I also had headaches, numbness and tingling. I ignored it. Then I started waking up at night with pain in my right ring finger. Fast forward and I have moderate carpal tunnel syndrome (EEM and nerve conduction study). They also found that I had several cervical issues during testing. I have been diagnosed with osteoarthritis of BOTH knees and a bunch of issues with my neck (see MRI report). I now am having locking and crepitus in my left shoulder, elbow, and same issues in left ring finger as right. My PCP says it is osteoarthritis as well, though he did not do xray or MRI. He says that with some people osteoarthritis just spreads. My question to you is, is there any type disease that could have caused/be causing my joints to develop osteoarthritis and though both DO's recommend surgery on my neck and knees, why bother if the disease is simply progressing throughout most joints? I am in constant pain. I also have osteopenia, hair loss, anemia, fatigue, headaches and stomach pain.

Answered by Dr. Dr. Shruti Rijhwani (22 minutes later)

Brief Answer:
Please send me your blood tests.

Detailed Answer:
Dear maam,

Thank you for posting your query.

I would like to know if your doctors have performed blood tests especially RF , ANA , ENA , Anti CCP antibodies, metabolic profile and Dexa scan. If yes, I would like to review those reports too. I see you have attached MRI reports but before I comment, I would like to review other reports too. So please do attach them if you have it with you. I would also like to know if you have any other relevant history. Please let me know and if any of your family member suffered from same issue.

Awaiting your response...

Dr. Shruti

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. Shruti Rijhwani (37 minutes later)

I have attached additional blood work and DEXA results. I also had an RA test done and it was negative for Rheumatoid arthritis.

I do have osteopenia, hypertension, peripheral neuropathy and anemia.

Answered by Dr. Dr. Shruti Rijhwani (2 hours later)

Brief Answer:
Follows.

Detailed Answer:
Dear Madam,

Thanks for reverting back.

Well I have gone through your reports and can see that there are extensive age related degenerative changes in your spine as well as knee . Since you say RF is negative so the possibility of rheumatoid arthritis goes down and for that matter any type of inflammatory arthritis goes down .

Your treating doctor is right in saying this that in some people osteoarthritic changes just progress and this specially runs in families . Even your age is also young for getting these kind of changes . The surgery for your knee is recommended; but I am not comfortable with spine surgery. You can discuss more about it with your surgeon. Since the spinal changes are not causing any red flag signs we should wait .

Coming to your question all inflammatory arthritis cause secondary osteoarthritis. But its not present in your case , so it may be genetic .

It is highly recommended to take calcium and vitamin D supplements for keeping bone healthy . Also avoid smoking in case you smoke . One thing I would recommend is getting ANA testing done as you seem to have multiple systems involved so ruling out Lupus is must .

Any other concerns we would love to answer.

Dr. Shruti

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Above answer was peer-reviewed by : Dr. Prasad