[39M] With sudden onset knee pain and swelling

Patient Description

A 39-year-old male presents with significant pain and swelling in the top outer side of the knee for the past three days. The pain is described as sharp and throbbing, especially when moving, and is accompanied by stiffness. The swelling is mostly puffy but can also feel firm and warm to the touch, and it comes and goes. Walking exacerbates the pain and swelling. The patient reports that the knee sometimes feels like it wants to give out and has popped once or twice. There is no redness or bruising, and no fever or chills have been noted. The patient has not experienced any recent injuries or accidents and has no history of knee injuries or surgeries. Family history includes arthritis, gout, and other joint-related conditions. The patient is currently using a soft-fitted knee brace for relief. Medications include those for depression, blood pressure, anxiety, an inhaler, and Suboxone, taken mostly twice a day as needed. No known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your knee pain and swelling:

  • Bursitis: This is the inflammation of the small fluid-filled sacs (bursae) that cushion the bones, tendons, and muscles near your joints. Bursitis often occurs in joints that perform frequent repetitive motion. The pain is usually sharp and can become throbbing with movement.

    • Treatment: Rest, ice, and over-the-counter anti-inflammatory medications like ibuprofen can help. A doctor may also recommend physical therapy or, in some cases, corticosteroid injections.
  • Tendonitis: This is the inflammation of the tendons, which are the thick cords that attach muscle to bone. It can cause sharp pain and swelling, especially with movement.

    • Treatment: Rest, ice, and anti-inflammatory medications are common treatments. Physical therapy may also be recommended.
  • Gout: This is a type of arthritis caused by the accumulation of urate crystals in your joint, leading to sudden and severe pain, redness, and swelling. Given your diet and family history, this could be a possibility.

    • Treatment: Medications to reduce uric acid levels and anti-inflammatory drugs can help manage gout. Dietary changes to reduce purine intake are also recommended.
  • Osteoarthritis: This is a common form of arthritis that occurs when the protective cartilage that cushions the ends of your bones wears down over time. It can cause pain, swelling, and stiffness.

    • Treatment: Pain relievers, anti-inflammatory medications, physical therapy, and lifestyle changes can help manage symptoms.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Rest and Ice: Rest your knee as much as possible and apply ice packs for 15-20 minutes several times a day to reduce swelling.
  2. Over-the-Counter Medications: Consider taking over-the-counter anti-inflammatory medications like ibuprofen or naproxen to help reduce pain and swelling.
  3. Elevate Your Leg: When resting, try to keep your leg elevated to help reduce swelling.
  4. Avoid Aggravating Activities: Limit activities that put stress on your knee, such as excessive walking or standing.
  5. Use a Knee Brace: Continue using your soft-fitted knee brace to provide support and stability.
  6. Hydration and Diet: Stay hydrated and consider reducing your intake of red meat and sugary foods, which can contribute to inflammation and conditions like gout.
  7. Symptom Tracking: Use MDandMe to journal your symptoms, track your progress, and share longitudinal medical notes with your healthcare provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • Increased Pain or Swelling: If your pain or swelling worsens despite home treatment.
  • Fever or Chills: If you develop a fever or chills, which could indicate an infection.
  • Inability to Move Your Knee: If you are unable to move your knee or bear weight on it.
  • Redness or Warmth: If you notice significant redness or warmth around the knee, which could indicate an infection or other serious condition.

Remember, while these suggestions can help manage your symptoms, it's important to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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4 mo ago

People Also Ask


What are the common causes of knee pain and swelling without a recent injury?

Common causes of knee pain and swelling without a recent injury include bursitis, tendonitis, gout, and osteoarthritis. These conditions can result from inflammation, repetitive motion, or the accumulation of urate crystals in the joint.


How can I differentiate between bursitis and tendonitis in the knee?

Bursitis typically involves inflammation of the bursae and presents with sharp, throbbing pain and swelling, often exacerbated by movement. Tendonitis involves inflammation of the tendons and also causes sharp pain and swelling, but it is more directly related to tendon movement and stress.


What lifestyle changes can help manage symptoms of gout?

To manage symptoms of gout, it is recommended to reduce intake of foods high in purines, such as red meat and sugary foods, stay hydrated, and maintain a healthy weight. Medications to lower uric acid levels and anti-inflammatory drugs can also be helpful.


When should I seek medical attention for knee pain and swelling?

You should seek medical attention if you experience increased pain or swelling despite home treatment, develop a fever or chills, are unable to move your knee or bear weight on it, or notice significant redness or warmth around the knee.


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