Unknown Chronic Inflammatory Disease in the right knee only

Patient

Q: I have an unknown chronic inflammatory disease in my right knee that causes constant pain. On May 31, 2012, which is the day after I came back from the Dominican Republic, my right knee swelled up and it never subsided. I did receive multiple mosquito bites while I was there but I do not know if this attributed to my now chronic pain. I did get sick for a couple of days after travel, but I attributed that to the change in climate. In August 2012, I had my orthopedic surgeon drain the fluid from my knee and he injected it with a steroid. The fluid from knee returned normal test results. In November 2012, I had arthroscopic exploratory knee surgery to relieve the swelling in my knee and also to try and pinpoint a cause for my inflammation. My orthopedic surgeon removed part of my synovium to biopsy because we both suspected I had PVNS and that test result came back negative. My test results did indicate that I had a high volume of plasma cells concentrated around my right knee but there was no explanation for that. In between August and November, I was also referred to a Rheumatologist to check for any auto immune diseases and his test came back negative for RA, SLE, Chlamydia, Gonorrhea, Gout, and Lyme disease. I did receive a positive ANA test result and a above normal SED rate which was not high enough to indicate anything. It is now March 2013 and I still have chronic knee inflammation in my right knee. No other joints are affected and I am not sure who else to go to for answers. I have physical therapy 2 times a week where iontenesis is performed and that seems to help short term. Does anyone have any insight as to what may be the cause of my right knee pain?

Doctor

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