Lesson of the month
Debilitating knee pain in a patient with "normal" radiographs
G K Meenagh, G D WrightDepartment of
Rheumatology, Royal Victoria Hospital, Belfast
Correspondence to: Dr G K Meenagh, Department of Rheumatology, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, UK garymeenagh@yahoo.co.uk
Accepted for publication 5 January
2001
| The first 150 words of the full text of this article appear below. |
 |
Case history |
|---|
A 67 year old woman presented with a one year history of increasing pain in both knees which was worse on activity. Initial examination showed small bilateral cool knee effusions with retropatellar crepitus. Radiographs showed mild patellofemoral osteoarthritis. No other abnormality was detected in the locomotor system.
Initial management comprised advice on weight and cushioned footwear, simple analgesia, quadriceps physiotherapy, and aspiration and injection of both knee joints with 40 mg triamcinolone hexacetonide. Six months later she was admitted to hospital because of severe debilitating knee pain resulting in inability to weight bear.
Examination showed mild wasting of the quadriceps muscles with
retropatellar crepitus and painful restriction of movement of both
knees. Repeat weightbearing knee radiographs (fig 1) showed no obvious
change from the initial study six months previously apart from the
impression of a high density shadow in the region of both lateral
femoral condyles. Further questioning showed excessive alcohol
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
