Help me get some kind of idea of what's wrong with my knee.

September 4, 2006 8:47 AM

Swollen knee, any ideas?

About a week ago I woke up with a slight tensing sensation in my right knee - specifically in the areas immediately above and below my kneecap. My assumption at the time was that I had merely tossed and turned myself into an odd position during the night and that I would be able to walk it off. A couple of days passed and that tenseness was still there, but there was no visible problem.

On Friday I went out with some friends for a street fair and spent a couple hours walking around downtown only to arrive home and notice that the area surrounding my kneecap had swelled significantly with some kind of liquid. Since then I've been elevating my right leg, alternating between icing and heating the area, and even using anti-histamine cream to try and stave off the swelling. None of these things have seemed to help. (Picture posted here)

I'm really at the end of my rope on what might be causing the problem. My knee still doesn't hurt, it's just swollen and awkward to walk on. I have a sneaking suspicion that it might be water on the knee, but I'm not sure what more I can do for myself besides wait for my new health insurance to kick in (new job starts tomorrow, coverage begins in a month) and just limp around until then? Any ideas or suggestions out there in the MetaFilter community?

posted by myodometer to health (12 comments total)

it sounds like there's something wrong with your cruciate ligaments

even if they're ruptured, there's no immediate need for surgery unless you work out or play sports
posted by matteo at 9:04 AM on September 4, 2006

INAD but I've had my fair share of knee problems. No real way of knowing what's wrong with you without flexing your knees to see where it hurts and possibly an MRI.

You should be OK until you can get to an orthopaedist when your insurance kicks in. Otherwise, stay off it as much as possible. Ice as often as you can (up to twenty minutes a time, up to five / six times a day, make sure you don't get frostbite). Lay off the heat - it makes inflammation worse. Ibuprofen (ie Advil) for the swelling and pain.
posted by TrashyRambo at 9:30 AM on September 4, 2006

I have had frequent knee and ankle problems (I'm hyperflexible in those joints). The one thing that works best for me when dealing with swelling is to take one of those Dixie paper bathroom cups and fill it 3/4 the way with water and stick it in the freezer (I do 5 at a time so they're available whenever). Then rip the cup off the ice, wrap the ice in a paper towel, and rub the rounded bottom of the ice around your joint for about 10 minutes. The combination of cold and pressure/massage really helps to get the fluid out of the joints. Though it may seem counterintuitive, drink lots of water/fluids, as that will help flush the bad stuff out, as well.

Warning - if your skin starts to turn very red or you start to really lose sensation or if it feels like it's burning, stop the icing immediately. I had a very mild case of frostbite on my ankle a few months ago from this technique. That said, it still helps a ton, you just have to be careful!!
posted by MeetMegan at 10:08 AM on September 4, 2006

It sounds to me more like cartilage damage than ligament damage. IANAD, but I've torn both ligaments and cartilage before. When the ligaments went, it was not the sort of thing where I hoped it would be alright and maybe posted an AskMe about it-more like the sort of situation where I went straight to the emergency room and, had I not been able to pay, would have performed sexual favors for strangers on the street until I could.

The cartilage was milder, just a bit of swelling, and pain that worsened when I exercised. Just try to stay off of it, and go to the doctor as soon as you can-you won't do any more significant damage in a month or two. Also, as others have mentioned, ice is definitely way better than heat.
posted by Kwine at 11:12 AM on September 4, 2006

I freeze tap water in empty water bottles for that, just leave a little headspace to allow for expansion.
posted by unrepentanthippie at 11:15 AM on September 4, 2006

INAD, but I used to get spontaneous knee swelling when I was a teenager. I found that icing the affected joint when it was bad helped, followed by wearing a simple knee brace (a glorified tensor bandage, available at any drug store) and taking aspirin as an anti-inflammatory worked wonders. I'd doubt that the anti-histamine cream would penetrate beyond a few layers of skin, so unless I'm mistaken you can discontinue that.
posted by senor biggles at 11:24 AM on September 4, 2006

Based on my history of various knee troubles (torn ligaments, sprained ligaments, torn cartilage, stress fractures...), I would definitely continue to ice it as others have described and discontinue heat, elevate it whenever possible, and wrap it in an ace bandage or a knee brace (compression helps with swelling). I might also take anti-inflammatories like Iburprofin. I would stay off it as much as possible until I could get to the doctor. And maybe even use a cane in the meantime if it's painful to walk on.
posted by nevers at 12:53 PM on September 4, 2006

A second for kwine's theory that it's the cartilage - like him I've had damage to both and ligament damage is unmistakable - there's very sharp pain. Here's a self-diagnostic chart which may help - although the advice is predictably "see a doctor" in most cases. An orthopaedic surgeon can test the ligaments very quickly with a simple practiced 'pull' on your lower leg - that will settle the issue in a few seconds.

Normal procedure would be arthroscopy which is a pretty simple operation to check the cartilage and clean it up if required. If you can't, or don't want to see a doctor, ibuprofen is the business, together with a large pack of frozen peas.
posted by grahamwell at 1:01 PM on September 4, 2006

When I had knee pain and swelling because of a cartilage problem, my MD told me to take 3 over-the-counter ibuprofen tablets three times a day. When the pain and swelling disappeared (after a week, in my case), I was to continue with the pills for one more week. During this time, I stayed off it as much as possible.

As I understand it, a swollen and tender knee essentially re-injures (or further injures) itself in normal activity. If you go back to your usual walking life too soon, you set the healing back.
posted by wryly at 1:10 PM on September 4, 2006

That flowchart above will (if I understand your symptoms) lead you to Prepatellar Burstitis. If that's correct, you're doing the right thing already and what you need is rest. Have a Google - you'll find this article which suggests that Antibiotics might also help.
posted by grahamwell at 1:22 PM on September 4, 2006

my knee spontaneously swelled up about three years ago and looked a lot like your picture. it didn't hurt, it was just stiff and uncomfortable. doctors thought it was bursitis, which was odd for a 20 year old. it turned out to be pigmented villanodular synovitis, aka, random knee swelling. if it is bursitis or pvns, doing exercises to strengthen your quad muscles will help put less strain on your knee and reduce swelling.
posted by kidsleepy at 8:26 PM on September 4, 2006

That flowchart above will (if I understand your symptoms) lead you to Prepatellar Burstitis. If that's correct, you're doing the right thing already and what you need is rest. Have a Google - you'll find this article which suggests that Antibiotics might also help

Exactly. This is as far from indicative of an intraarticular injury as they get. You are doing all the right things. Get into see your doctor sometime soon if it isn't better.
posted by docpops at 9:05 PM on September 4, 2006