Dr. Das Biswajit
Orthopedician and Traumatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I am a 31-year-old. My body weight is 158 pounds and height is 5 feet and 8 inches. I have a pain just behind the knee for the last five months and I feel it while standing from sitting position. If I sit on legs, then I feel stiffness in the back of the knee. Also, I cannot stand properly for more than a few minutes. Here, my local doctor took the blood sample for ESR and CBC. He said everything is fine. My uric acid is 6.30 mg/dL. There is no complication in my X-rays. He prescribed me the following medicines. Etorvel 90, Vitamin D3 (60,000 IU) once in a week and Uristat I have been taking all these for the past three days. But, still my problem persists. Kindly suggest your opinion.
Hi,
Welcome to icliniq.com.
As per your history the problem has been long standing for around five months or more. I advise you to visit a nearest physiotherapist to start and continue knee physiotherapy. Abstain from sporting activity for a few weeks. If after around four to six weeks your symptoms do not improve, then my advice is to go for MRI of the affected knee for possible ligaments or meniscal lesion like cysts or any synovial changes.
The Probable causes
Investigations to be done
Differential diagnosis
Treatment plan
Preventive measures
Patient's Query
Hi doctor,
Shall I continue the medicines that I mentioned? Or shall I stop?
Hi,
Welcome back to icliniq.com.
Continue Etorvel 90 (Etoricoxib) once daily for another three weeks along with physiotherapy, hot water fomentation, Diclofenac gel and knee cap. After three weeks stop Etorvel and continue the rest of the treatment. If pain is mild or occasional, then you can take it SOS (as and when necessary). Can you send me your x-rays?
Patient's Query
Hi doctor,
I have attached my X-rays for your reference. My local doctor has also prescribed me Alnacal forte, which contains Omega 3 fatty acid, Methylcobalamin, Calcitriol and folic acid. Daily morning, after toilet, I cannot stand properly as it is very much painful.
Hi,
Welcome back to icliniq.com.
Since it is only three days you have started medication you have to wait for another four days. At the end of the first week if there is no improvement in pain or if the pain is severe, then change Etorvel 90 to Zerodol-P (combination of Aceclofenac and Paracetamol) twice daily after food for two weeks along with Pantocid-DSR once daily in empty stomach. Other medications you mentioned are not important in this situation. Consult your doctor, discuss with him or her, and take the medicine with consent. You never mentioned the affected side of the knee. On X-ray, it appears (attachment removed to protect patient identity) your left knee medial joint space is slightly decreased. It may be the cause of your symptoms. Anyhow, it is better to go for MRI for further information about your knee.
Patient's Query
Thank you doctor,
Yes, I have pain in both knees. But, the major problem is in the left one.
Hi,
Welcome back to icliniq.com.
Please try to get the MRI as soon as possible. Do not hesitate to revert back for further doubts.
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Orthopedician and Traumatology
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