New information on knees - osteochondral defect

[marionofnorwich]

Eventually I got an x-ray on my knees last month and wasn't really expecting it to show anything but apparently I have mild (one knee) and mild/moderate 'osteochondral defect' which as far as I can tell is damage to the knee bones and cartilage either caused by injury trauma (I can't think of anything) or an interruption to the blood supply to the knee (makes more sense). This can apparently be brought on by steroids.

Has anyone else experienced this? It explains why I have had extreme knee pain and very tight calf and thigh muscles, trying to support the knee joint. But not sure where it leaves me as not sure how much is PMR and how much is mechanical damage, but feeling that I need to get off the pred as soon as I can.

Only just got the test result so waiting for a phone appointment with the doctor on 8 November but can't stop thinking about what I can do to help myself eg increase blood supply to the knee

[PMRpro Ambassador]

I doubt there is much you can do on your own - as I understand it, it is a very focal problem - except restricting activity and seeking physio as the conservative approaches. Beyond that, surgery becomes the option.

ncbi.nlm.nih.gov/pmc/articl...

Which they choose will depend on the size of the lesion - but in the current UK climate I imagine it will be conservative first if possible.

[marionofnorwich in reply to PMRpro]

Thanks PMR Pro. I am impatient now to have a proper consultation. I wish that I had gone to A&E a few months ago when they were really bad. Thankfully now just weak and stiff and impacting on surrounding muscles but back in may it felt like they had been hit by a hammer, especially the right knee. Still waiting to hear back from Max Yates about a referral to the clinical trial for biologics - that would help to get me off the steroids

[jinasc]

Try Flexiseq - a bio logical cream which works like WD40 and is great for Osteo. Without its help I would be in constant pain in my knees, hands etc. The best thing about it - not a drug so no side effects.

I have been using it since it was introduced by ARC research.

[marionofnorwich in reply to jinasc]

Thanks, I will take a look

[Janbay46]

I'm interested to read that someone else is having major knee problems. I first developed PMR in my knees, severe pain and weakness which spread over the next 6 weeks to hands, feet and shoulders. I was then diagnosed and prescribed pred by an excellent rheumy, the pain disappreaed in hours like magic. Later I had a major flare, not in knees but in hands and feet, I think caused by a covid booster. I went back to a high pred dose, but it was slow to take effect.

A year later, I have had very weak, painful knees all summer, behind the knee and up the back of the thigh. The knee joints themselves are fine, it seems to be muscles or whatever. I think it may have been caused by a long hike in the Welsh mountains in June, I'm an overweight 76-year-old so would have been overdoing it even without PMR. I found Pilates and swimming in heated pools helped, but the main cure was time. But they are Ok now, five months later!

[marionofnorwich in reply to Janbay46]

Yes although my PMR started in March 2020 with very stiff neck and shoulders, then hips and thighs which is more typical. 15mg of pred got me mobile again within 3 days and I felt great. Tapering went OK till 6mg and then I started to feel a but stiff but carried on tapering as I felt I could. Just before I got Covid in April 2022 I reduced from 5 to 4mg and the back of my legs felt tight and stiff, but in hindsight, I had previously told my doctor that the back of my leg behind my knee felt swollen and lumpy. He said it was just muscle but it felt 'in the way' when I bent my knee, and tender. Then Covid seemed to blow everything up and my knee (actual joint in the inner side) was agony for a few weeks. I should have gone to A&E then but I did the right thing and went via my GP. A referral for knee xrays took 5 months to come through and in the meantime, the acute knee pain has subsided with the help of my osteopath and some acupuncture and ultrasound but the backs of my legs are still tight and my left hip weak but it is improving rather than getting worse so I am a bit thrown by the xray results until I see a specialist which I hope won't be long (she says, feint hope!)

[jinasc]

I am pleased that you will look at it - however on re-reading your post - I doubt if it will help. I thought you had written osteoarthritis. No matter the ARC site will let you see if it will help.

I can get the wrong end of the stick sometimes.

[marionofnorwich in reply to jinasc]

Yes, it is perhaps almost the opposite to osteo-arthritis and thankfully the intense pain that I had a few months ago has gone but that is maybe because I raised my steroid dose back up to 10mg and I am tapering down again but still higher at 7.5mg than I was when the pain was first apparent ie at 4mg having just reduced from 5mg (at that time I didn't know better than to go more gently). As @janbay46 says, it has been accompanied by very tight muscles behind the knee and up the back of my legs which I have attributed to PMR but might just be trying to support the knee.

[PMRpro Ambassador in reply to marionofnorwich]

If you want to link a person. after typing @ and starting the name, a selection box comes up. You must click on their name in that to make the link which will appear in blue when you post

[marionofnorwich]

Ah OK, thank you PMRpro

[PMRpro Ambassador in reply to marionofnorwich]

Quick learner