My knee joints make noises but it is not painful. What can be done?

Question

Hello doctor,

I am a 34-year-old male. Three to four months ago, my knee joints started to make noises. But it is not painful. And, when I drive for a long time and get out of the car, my left knee, which is used to press the clutch, has a sharp pain. But, it is only once when I first step outside the car. After that, everything is fine. But I decided to show an orthopedic. I visited a specialist, and he went for an X-ray. And after taking X-rays, he told that the knee gap in both legs had got bigger than normal, especially the left leg. He suggested me to take physiotherapy and medicines. I would like to know if this condition can be cured completely. What precautions should be taken to avoid a future problem? I do yoga, aerobics, and jumping every day.

Answer 1

Hello,

Welcome to icliniq.com.

I saw your X-rays (attachment removed to protect patient identity). You seem to have medial compartment osteoarthritis with a possibility of spontaneous osteonecrosis of the left knee (SPONK). Check SPONK in left knee. You need to do an MRI scan and I would also suggest you do some blood investigations as I have given below. Till then, you need to take the following tablets:

1. Tablet Ibuprofen (400 mg) twice a day for 10 days after food.

2. Tablet Rabeprazole (20 mg) in the morning for 10 days before food.

3. Tablet Shelcal (Calcium) (500 mg) in the morning for 30 days before food.

4. Tablet Vitamin D (60 K) once daily for 10 days, then once a month for 11 months.

Take these tablets only if you are not allergic to them. Do not take these tablets if you are a known case of bronchial asthma. Follow up immediately in case of any untoward reactions. Activities that cause pain should be avoided temporarily. If the knee is swollen or sore, the following positions and activities should be avoided until knee pain and swelling resolve:

1. Squatting.

2. Kneeling.

3. Twisting and pivoting.

4. Jogging.

5. Aerobics.

6. Dancing.

7. Playing sport.

8. Yoga positions which place high pressure on the knee joint.

You should wear a knee cap for support to the knee joint. Wear it all day and you can remove it at night. Apply mild heating pads twice daily for 15 minutes each.You need to get the following blood tests done:

1.CBC.

2. ESR.

3. Serum vitamin D3.

4. Serum vitamin B12.

6. Serum electrolytes.

Start taking vitamin tablets only after blood tests.

You need to do a left knee MRI scan - plain.Do the blood tests and MRI scan and upload reports for accurate advice.Regards.This is only a second-opinion platform. This professional advice provided by me stands subject to the actual examination of report/image and is based entirely on inputs provided to me. It should be correlated with clinical findings.

Answer 2

Hello,

Welcome back to icliniq.com.

Yes, I need to see the MRI scan results, too, and ask them to especially look for bone edema (or SPONK). Upload the blood and MRI results.

Regards.

Answer 3

Hi,

Welcome to back to icliniq.com.

The pain is only due to osteoarthritis. So, you just need to continue tablets and exercises and precautions as mentioned in the first chat.

1. Physiotherapy - quadriceps strengthening exercises.

2. VMO strengthening exercises.

3. Hamstring strengthening exercises.

4. Hip abductor strengthening,

And follow up after two months.

Regards.