What Causes Pain In Both Knees Along With Difficulty Walking?

Posted on Tue, 25 Nov 2014

Question: Hello, My dad is 67 and has recently began to feel pain in both knees (mostly in the front, but sometimes it only hurts in the back of his knees). There have been a couple of times that when he is walking they give out and he has to grab something to keep from falling. He is very healthy, not overweight at all, and this just started. It is NOT because of an injury and it started in both knees at the same time. Any ideas what this may be?? Thank you!!

Answered by Dr. Dr. Muhammad Sareer Khalil (1 hour later)

Brief Answer:
explained

Detailed Answer:
hello and welcome

I appreciate your concern.

I have read your history carefully. The overall picture points towards osteoarthritis. Specific diagnosis can only be done if specific investigations are sent after a physical exam. If there is an acute flare Nsaids short course like diclofenac sodium with PPI cover for a week can be empirically started to see for improvement.

Vitamin D and calcium levels, including an osteoporosis workup should also be done in consult with your doctor. The relevant deficiencies can be corrected afterwards.

Please get the routine investigations done for him via your PCP including
CBC, LFTS, UREA CREATININE, ELECTROLYTES, DOPPLER U/S ( IF INDICATED ON PHYSICAL EXAM). URINE R/E, URIC ACID LEVELS, HBA1C AND B.P MEASUREMENT SHOULD ALSO BE DONE.

LET ME KNOW IF YOU HAVE ANY QUERY

Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Muhammad Sareer Khalil (27 minutes later)

I understand he needs to have bloodwork and visit his physician. That's a given.
My question is what are some possibilities that this can be?? Cancer, PAD, ect. I know you can't give an actual diagnosis but can you tell me what things it could be?

Answered by Dr. Dr. Muhammad Sareer Khalil (12 hours later)

Brief Answer:
explained

Detailed Answer:
hello again,

Unless there are marked irregularities in TLC on blood work, cancer is highly unlikely. Peripheral Arterial disease would have presented with vivid complain of claudication.

Even though Osteoarthritis would still remain at the top of the differential diagnosis, Poly articular symmetrical joint involvement is commonly seen in Rheumatoid arthritis, SLE, Hepatitis B , Parvovirus B19 infection.

If there is a mono articular flare and involvement, joint aspiration would be necessary to rule out septic arthritis, if there is evidence of joint inflammation eg ESR or physical exam.

Skin, Kidney and glandular manifestations need to be ruled out to narrow the diagnosis, via a physical exam and targeted investigations based on the physical.

thanks.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar