Knee - Baker's cyst rupture with fluid collection and Articular Patellar Cartilage problem

Patient

Q: Hi. I have had lumbar back pain since years now and a couple of months ago developed a knee pain which I prolonged. I went to an Ortho and he had some xrays and tests done and it showed narrowing of joint spaces in lumbar spine and knee and a tibial spiking in knee. He advised physio and the back went better but a point on the knee near the articular cartilage kept hurting. Should also mention I had a bruise on the knee around the same area when I went to the dr the first time. Don't know how I got it though. Also one day there was a needle lying around on the bed and I didnt see it and it went half into the knee a little lower than the bruise point. Since after the physio there was no improvement the dr. had an MRI taken. The results showed: evidence of elongated localised fluid collection at the posterior aspect of the medial tibio femoral compartment in subcutaneous location, probably originating between distal head of semi membraneous muscle and medial head of gastrocnemius muscle showing few adjacent dispersed fluid collection as well. cranio caudally is measuring 6 cms. lesion best seen on fat compressed coronal images. This is most likely a ruptured Bakers cyst. Articular patellar cartilage us thinned out and occasional slight denudation of articular surface. I started on more physio for the knee with some exercises to strengthen the hamstring. Also been taking a walk now. This MRI was taken on November 2nd. The issue is after 28 sessions of physio the pain mostly at the articular cartilage point which I mentioned earlier, still lingers at times. During a walk - not too brisk or too slow - my calf and the back of the knee hurt. When I flex my knee the pain is immense. The pain is not constant but definitely present there. Some days it hurts just like that and some days with exertion. I have been asked to not climb steps but my office is such that to get to the elevator I need to climb 23 steps everyday. Dr. has asked me to limit it to once a day but on certain days due to work I have to more than once and the pain definitely flairs. Dr. also says due to joint space reduction and slight beginning of osteoarthritis in knee the pain will take its own time to go. Have also been told not to drive. The thing is that this is now becoming a concern for me as the pain I would say has reduced by 7%-10% only and I see a long way to go this way. Should also mention out there that the lumbar back pain I have sometimes radiates from lower back all the way down to the ankle and sometimes from butt muscle down to ankle. The thigh muscle gets a bit spasmic and then the knee hurts more. A 50mg Ibuprofen tablet usually does the trick.

Do you have any other advice for me?
Thanks.
Arnaz

Doctor

A:   Thank you for your question. The progression of your illness requires a longer recovery period and you may need to continue with your current treatment regimen. What we can suggest is that if your pain becomes more severe, you may benefit from a stronger oral analgesic medication. However, all remaining equal we recommend that you follow your doctor's recommendations accordingly, and if any symptoms become worse please follow up with them as soon as possible.

AskTheDoctor.com wishes you a rapid recovery.

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