Two months ago my mother fell down on her knees but did not seem to complain. Recently, she did a bit of house work for a few days and her knee is in pain especially in the back where you bend your leg. Pain is also notable when she sits down for an hour or longer and gets up, and also when waking after sleep.
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Your mother has osteoarthritis of the knee and the fall may have stirred this further. The pain that you describe is at the back of the knee this can come from the knee cap as well as the degenerative tear of the medial meniscus. As there are a very little mechanical symptom like locking and giving way not there is much of an effusion I feel that the pain is from the knee cap.
The pain in such cases can be at the back of the knee, pain is worse in climbing stairs or coming down, worse after having sat down for any length of time. This condition is called patellofemoral compression syndrome and can be helped with regular exercise and patellar gaping and a course of anti-inflammatory medications like Diclofenac or Piroxicam. In addition, she can take Paracetamol and Tramadol combination for pain.
She will need to do VMO, gluteal, core strengthening exercise, and hamstrings stretches, in addition, she needs to avoid squatting. The physiotherapist can in addition give IFT or TENs to help. it will take 3-6 months for the pain to settle down.
MRI also shows an incarcerated needle tip under the patella have but I need to have this physically checked if this was recent and was it from the fall on to a sharp object.
Thank you doctor,
She fell on the street, and I am not sure if there was any sharp object, maybe she hit a small pebble, or is there an actually nail punctured? Also, I sent the other part of the MRI and picture of the back of the knee where the pain is. It is a little dark colored and painful while touching.
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I have seen the picture. (attachment removed to protect patient identity).
Yes, I can see a bruise at the back of the knee and surely it will be tender to touch. I will recommend in addition to the above prescription to apply ice to the area of bruise for 15 minutes every alternate hour. She can also apply a pain-relieving gel when she is not icing, make sure that there is a gap of 45 minutes between applying the ice and the gel and vice versa.
As far as the sharp object is concerned, I will not panic at the moment and will like to see the pain response to the medication and local therapy for at least two weeks before I start to worry. I feel that pain should respond well during this time and please observe the precautions that I discussed i.e. not squatting during this time period. Keep an eye on the size of the bruising also.
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