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Q. I have severe burning pain in my left knee. Could this be rheumatoid arthritis or an effusion?

Answered by
Dr. Atul Prakash
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 24, 2021

Hello doctor,

I am 53 years old with no significant medical history. I have been trying to lose weight and recently increase my level of activity by practicing yoga for 20 minutes a day. I am 5'2,'' and my weight is 141 pounds. Around last week I noticed some edema on my left upper knee that made walking a little difficult. It is not painful, but I was uncomfortable bending my knee as I could feel the extra tissue or edema. Today my inner left thigh started with a burning and sharp pain. The pain is severe and gets worse by standing. Straightening my leg hurts the back of my inner upper thigh. I have to work tomorrow from 8 AM to 8 PM. Should I call sick tonight to follow up with my doctor tomorrow? Is it something serious such as a blood clot, that I have to be concerned about? My CBC, BNP, UA, cholesterol level, and blood sugar level are all normal. I am taking a Multivitamin tablet once a day.

#

Hello,

Welcome to icliniq.com.

Yes, there is a visible difference in the circumference of the left thigh (attachments removed to protect the patient's identity). It is difficult to be precise as the history and examination findings are limited. There is no history of injury. You are not at risk of DVT (deep vein thrombosis) as such. No diabetes, your BMI (body mass index) is fine, you are not on the pill, you are active till this happened, and there is no history of fever. There is no swelling in the calf, neither is there any color change. The points of concern are swelling (spontaneous onset), pain burning in nature and the fact that you are having difficulty walking, standing, and straightening the knee. It is entirely possible that you may have stretched the thigh, knee, or hamstring while doing yoga. This, however, would not explain burning pain. My suggestion will be to rest the leg, elevate and take anti-inflammatory tablets like Piroxicam or Naproxen and keep ice on the sore area. See if this helps in a day or two. If you are no better, then see a doctor for examination and diagnosis. Highly unlikely it to be a clot, but a formal examination is required. Please get back if you have further queries.

Hi doctor,

Thank you.

Could this be effusion or RA? I am attaching an image for your reference.

#

Hello,

Welcome back to icliniq.com.

There seems to be a swelling around the knee (attachments removed to protect the patient's identity). Without examining you, it is difficult to differentiate between an effusion versus an extra-articular swelling. If you feel bending the knee makes you feel tight and stiff, it is likely that this is an effusion. This could be sympathetic to inflammation and swelling close by rheumatoid arthritis RA can present as a monoarticular swelling. Still, there will be no swelling outside the knee, and there should be no burning pain in the thigh. I will recommend you wait and try the rest, ice, and anti-inflammatory tablets to see if this helps. Is there family history, and do you have morning stiffness in the small joints of the hand? Please answer the question so that I can guide you accordingly.


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