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'alternating knee' nightly ache, advice appreciated, Dx even better

Discussion in 'Biomechanics, Sports and Foot orthoses' started by markjohconley, May 7, 2020.

  1. markjohconley

    markjohconley Well-Known Member

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    I’m hoping for advice / dx regarding personal knee problem

    66 y/o male, overweight, inactive

    was very active as a teenager, gymnastics, swimming, rugby league (a lot of running from 14 y/o

    Chief Complaint (CC)
    Of recent onset I have had a nightly ache in knees > ache alternates nightly,
    constant ache not sharp, not throbbing, painful enough to keep me awake, but eases after ~10 minutes upright
    restricted to the whole of knee, NOT reminiscent of gout like (have had gout a lot before renal transplant)

    History of Present Illness (HPI)
    Post renal transplant ‘16
    medications for antihypertensives, Bactrim (for kidney/bladder), oral hypoglycaemic agents, allopurinol (100mg bd), others …

    Past Medical History (PMH)
    Have chronic kidney disease that required a renal transplant 4 YA
    before transplant had frequent gout episodes usually ending in b/knees >incapacitated
    b/knees hx menisectomies, MCL ruptures and R/anterior cruciate ligament rupture / repair ‘’72 (the old way, have metallic ties? (and big scar) > orthopod threatened knee reconstructive surgery ~ 8 YA > orthopod claimed imaging showed there was NO medial articular cartilage on R/knee

    any help appreciated
    could go to GP but my confidence in GP’s has taken a biggish hit lately
    wouldn’t go back to ortho, scalpel / drill ‘happy’
    thanks, mark
  2. markjohconley

    markjohconley Well-Known Member

    i have been proofread by my good wife and she points out that i misled in op
    the, "...ache alternates nightly... ", should have read that the ache has only occurred 5 times of sufficient magnitude that i have been awakened by it and only on one occasion that it was successive nights BUT the weird (to me) characteristic is that is has been in alternating knees ???
    if i don't get a reply Admin i think i should be honoured? with the award of 'Most Threads Never Replied To', what do you think ...
  3. Mark_M

    Mark_M Active Member

    Hi Mark,
    I'm only replying so you don't get that award ...haha ha.

    Is there a reason why you haven't diagnosed yourself with osteo-arthritis? you tick a lot of boxes
    That ache at night can often comes from the patella - chondromalacia patella
    With all this lock down, too much sitting causing contraction/tightness of rec fem.
    Try some quad stretches, or exercise bike.
  4. markjohconley

    markjohconley Well-Known Member

    Thanks Mark,
    yep you've stuffed any chance of that award ...
    the ache hasn't been reminiscent of the pains i've had when dx with o/a; i certainly do '...tick a lot of boxes'
    the ache, which has been a nocturnal occurrence has been a general knee pain, reminds me of the post immediately post-ACL repair but down a few notched; it hasn't been localised within the knee and i haven't perceived any crepitus, no swelling, no immobilty at time so perplexed ...
    certainly a lot of sitting so imagine quad contractions but thought rectus fem. wouldn't be so as flexed hips?
    good advice but i loathe stretching and though a huge fan of road cycling personally it iritates b/1st mpj's
    anyhow, thanks, all the best
  5. markjohconley

    markjohconley Well-Known Member

    Mark_M you're right according to the orthopaed i saw yesterday (had to go to sydney as couldn't get in here in canberra for 3/12). According to him, "...most likely O/A...", "...atypical presentation...", and when asked about the alternating pattern "... random..."

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