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What Do My Lab Test Reports Indicate?
Question: My brother suffered an acute knee joint pain some months ago over night .The doctor we consulted diagnosed it as acute Synovial Effusions and prescribed some pain killers and drugs. The pain subsided within a week and he became normal.
However when every thing looked normal for days together this sudden over night pain returned without any warning a few days ago. We took him to the same doctor once again and he prescribed additional drugs and pain killers. He also advised complete rest and an X ray of the knee.
The pain does reduce during the day time but returns in the morning after a night's sleep. There does not seem to be any permanent solution for his ailment although the doctor does keep changing the drugs
I am attaching all the relevant papers along with the X ray results with a request to let me know all the detailed diagnostic tests that he needs to do to ascertain the precise problem in his case.
with brgds XXXXXXX
However when every thing looked normal for days together this sudden over night pain returned without any warning a few days ago. We took him to the same doctor once again and he prescribed additional drugs and pain killers. He also advised complete rest and an X ray of the knee.
The pain does reduce during the day time but returns in the morning after a night's sleep. There does not seem to be any permanent solution for his ailment although the doctor does keep changing the drugs
I am attaching all the relevant papers along with the X ray results with a request to let me know all the detailed diagnostic tests that he needs to do to ascertain the precise problem in his case.
with brgds XXXXXXX
Brief Answer:
Degenerative changes in knee.
Detailed Answer:
Hello,
Thanks for posting your query.
I have seen the attached reports.
The knee joint shows mild degenerative changes secondary to wear and tear. These are age related changes and is not suggestive of a serious ailment. You can get an MRI scan of the knee done to confirm these findings.
The treatment options include pain killers, hot fomentation, lubricating agents like glucosamine sulfate, chondroitin , dycerin, etc and some life style modifications and physiotherapy.
He can start with walking and aerobic fitness exercises, quadriceps strengthening, patellar tapping, lateral heel wedges, etc- under the guidance of a physiotherapist.
A Big No to Stair case, squatting postures, any chair which has a sitting platform lower than the knees.
Knee brace can also be used for an earlier and prolonged relief.
In severe cases intra articular injections of steroids and hyaluronic acid may be needed after consultation with your orthopaedician.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Degenerative changes in knee.
Detailed Answer:
Hello,
Thanks for posting your query.
I have seen the attached reports.
The knee joint shows mild degenerative changes secondary to wear and tear. These are age related changes and is not suggestive of a serious ailment. You can get an MRI scan of the knee done to confirm these findings.
The treatment options include pain killers, hot fomentation, lubricating agents like glucosamine sulfate, chondroitin , dycerin, etc and some life style modifications and physiotherapy.
He can start with walking and aerobic fitness exercises, quadriceps strengthening, patellar tapping, lateral heel wedges, etc- under the guidance of a physiotherapist.
A Big No to Stair case, squatting postures, any chair which has a sitting platform lower than the knees.
Knee brace can also be used for an earlier and prolonged relief.
In severe cases intra articular injections of steroids and hyaluronic acid may be needed after consultation with your orthopaedician.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
I agree with all you have written about possible treatment and guidelines for prevention but there seems to be some factor that causes sudden overnight onset of intense pain without any kind of warning. We are more interested in knowing why this happens even without the slightest discomfort just before going to bed. A few hours before bed he is OK but a few hours later he is unable to even get up let alone walk.
Besides age related degeneration as indicated in the Xray are there any blood test etc. that needs to be done to check what kind of activity in the night while in bed causes this problem.
Do you think we should also look into the possibility of gout? or any other similar ailment?
Is it also because of any diet that he should not be taking. He does not drink or smoke. He is a non-vegetarian.
He also suffers from asthma and every now and then uses an inhaler. Any side effects due to this?
with brgds XXXXXXX
I agree with all you have written about possible treatment and guidelines for prevention but there seems to be some factor that causes sudden overnight onset of intense pain without any kind of warning. We are more interested in knowing why this happens even without the slightest discomfort just before going to bed. A few hours before bed he is OK but a few hours later he is unable to even get up let alone walk.
Besides age related degeneration as indicated in the Xray are there any blood test etc. that needs to be done to check what kind of activity in the night while in bed causes this problem.
Do you think we should also look into the possibility of gout? or any other similar ailment?
Is it also because of any diet that he should not be taking. He does not drink or smoke. He is a non-vegetarian.
He also suffers from asthma and every now and then uses an inhaler. Any side effects due to this?
with brgds XXXXXXX
Brief Answer:
Few blood investigations are needed.
Detailed Answer:
Hello.
Thanks for writing again.
The sudden onset of intense pain can be due to muscle cramps, electrolyte disturbance, decreased fluid intake, low levels of calcium, etc. A few blood investigations will help in ruling out all these conditions. Gout is unlikely. Taking non vegetarian diet can aggravate gout. Inhaler does not affect this.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Few blood investigations are needed.
Detailed Answer:
Hello.
Thanks for writing again.
The sudden onset of intense pain can be due to muscle cramps, electrolyte disturbance, decreased fluid intake, low levels of calcium, etc. A few blood investigations will help in ruling out all these conditions. Gout is unlikely. Taking non vegetarian diet can aggravate gout. Inhaler does not affect this.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
Thank you for your reply. My brother does take non vegetarian food but may be he can restrict it. You have not indicated what blood investigations to be done in the "Few blood investigations" you have referred to in your reply . Can you kindly mention these tests so that we can carry them out immediately.
Thank you for your reply. My brother does take non vegetarian food but may be he can restrict it. You have not indicated what blood investigations to be done in the "Few blood investigations" you have referred to in your reply . Can you kindly mention these tests so that we can carry them out immediately.
Brief Answer:
Tests mentioned below.
Detailed Answer:
Restricting the non vegetarian food will help. For proper diagnosis, some of the blood tests are advisable like-
1. Serum calcium levels.
2. Serum Uric acid levels.
3. RA factor
4. ESR and CRP
5. Serum Creatinine
6. Serum Vitamin D3 levels.
Regards.
Tests mentioned below.
Detailed Answer:
Restricting the non vegetarian food will help. For proper diagnosis, some of the blood tests are advisable like-
1. Serum calcium levels.
2. Serum Uric acid levels.
3. RA factor
4. ESR and CRP
5. Serum Creatinine
6. Serum Vitamin D3 levels.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
Please see the reports that I have attached with the tests suggested by you. Let me know your comments and remedies.
Please see the reports that I have attached with the tests suggested by you. Let me know your comments and remedies.
Brief Answer:
Low grade infection likely.
Detailed Answer:
I have seen the attached reports. His ESR, CRP and TLC are increased. All these are suggestive of a low grade pyogenic infection in the knee. It is best to start with oral broad spectrum antibiotics after consulting your orthopedician. He will clinically assess the degree of effusion and will prescribe a suitable antibiotic for him.
Regards.
Low grade infection likely.
Detailed Answer:
I have seen the attached reports. His ESR, CRP and TLC are increased. All these are suggestive of a low grade pyogenic infection in the knee. It is best to start with oral broad spectrum antibiotics after consulting your orthopedician. He will clinically assess the degree of effusion and will prescribe a suitable antibiotic for him.
Regards.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Raju A.T
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