In Jan 2016 my husband had a swollen knee.

Patient

Q: In Jan.. 2016 my husband had a swollen knee. x-ray showed a damaged meniscus. The knee was very swollen and then down to the foot. Dr. drained 3 vials of fluid from knee. From then on, Richard had terrible pain not only in knee, but shoulders (felt like boils he said), swollen hands and literal pain from head to toe. Eventually the swollen leg went back to normal but the swelling in hands mostly remains. Hard to even open a door, put on clothing, holding a cup or glass takes two hands. Dr put him on Norco. Starting his third bottle. Still has pain, lack of sleep, and when he went to emergency room they gave him something to temporarily diminish pain but he said shoulders and hands still hurt. Hospital Dr. said he needed to see a rheumatologist. Now they just said his appt. wont be until June 8. He wondered why nothing could be done to analyze the immediate situation. Who or what could be consulted? He had to call off the surgery to his knee as the fever and pain to the rest of his body would be intolerable. Anesthesiologist recommended following up with his Dr. to see if he was coming down with something. Had several more fevers not over 101. Blood tests said he had elevated leucocytes. Not enough for them to proceed further I guess. A small amount of blood in urine; low sodium. Just don't know where to go for other consultations.

Doctor

A:   Hi.
Thanks for your query.
Read the history related to your husband and understood the complexity and concerns.
I can understand the situation you both must have been going through.

I would advise you the following in such a condition:
- Consult an Orthopedic Surgeon, may be a second opinion of another for clinical evaluation, examination and further investigations. This is till you get to be seen by the Rheumatologist.
You can discuss the following points with him and your family Physician.
- Blood: CBC, thyroid, liver, kidney functions; Rheumatoid factor, ESR, blood culture and sensitivity may help, tests for autoimmune disorders as per clinical evaluation.
- MRI of Knee joint
- What were the reports of the fluid removed from knee joint and other reports that must have been done so far?
- Urine analysis.
-Ultrasonography of the abdomen, particularly for genito-urinary system, referral to Urologist if the reports indicate such a problem.
- Other tests as may be required.
- Proper medical management as per the symptoms, clinical evaluation, lab reports, response to earlier treatment. This may be in the form of an antibiotic, anti-inflammatory medicines and may contain oral steroids in tapering dosages and so on. Addition of multivitamins as an anti-oxidants helps. Mere painkillers will not help the disease process.
- Physical exercises under the care of a Physiotherapist to maintain the muscle mass and power.

I hope this answer helps you to some extent, please give the feedback about the progress on all these fronts, what was achieved, what is planned and helped by any of the Doctors concerned so that we can discuss further.
Please feel free to ask for further relevant queries if you feel that there is a gap of communication.

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