The rheumatologist made the promised call, sharing the recent bloodtest results. Blood is fine. No indications for auto-immune disorder. So, it looks like the inflammation has been halted. Yeah.
Then his question: how are you? Well, the knee is still normal after almost three weeks. Good. Sounds like you are back to normal. With this restriction: no peak muscle stress advised for the next three months.
So, refereeing will have to wait till January. In the meantime it’s important not to trigger a new inflammation and not put too much pressure on the knee muscles.
I’m ok with that as long as I can go about without pain and stiffness. And no new medication. Four months of a weird sudden inflammation seem over. Maybe ignited by a heavy sports season afterall. Full circle after all.
This week, another much anticipated hospital appointment took place. It was to become a new discomforting medical talk.
It all started with good news. The rheumatologist told me no real abnormalities were found in either bloodtest or new x-ray photos. More importantly, no crystals whatsoever were found in the excessive knee fluids het extracted last time. Meaning, it is almost certainly not gout or ‘pseudo-gout’ (chondrocalcinosis). The bad news was slowly building up in my mind. And made written notes this time to remember the test results in more detail.
The specialist suggested one more fluid extraction from my swollen knee and wile the needle was still in, inject it with double the volume of corticosteroid in order to try once again kill the stubborn inflammation. I agreed as this seemed the last effort to cure the 15 weeks knee misery. In two weeks time, a 3rd extraction (if anything left) will take place for a final check on pseudo-gout. And another blood test.
I had to ask the question: so doc, what’s next if all this doesn’t work out? Well, if it’s definitely no gout (and that’s already for 99% certain), we are entering the early indication of the rheuma realm. A new therapy will need to be started and another medication to stop the inflammation. Probably back to a prednisolon course.
The injection was less comfortable than the previous extraction. The medication was added and I was instructed to keep calm for 2 days and then slowly try to exercise. In the meantime, I keep my fingers crossed.
After seeing the sports medical doctor, I learned to accept that my swollen knee wasn’t due to a sports injury, but rather an ailment. Changing from the orthopedist (mechanical) to a rheumatologist (inflammatory) should be regarded as logical therefore. Suffering twelve weeks of this kind of swelling (and only a swift pain attack) simply can’t be blamed on excessive sports stress or trauma.
No, the diagnosis probably goes in the direction of my GP’s first hunch back in May: gout or pseudo-gout (chondrocalcinosis). Gout is an ailment in the rheumatic line, caused by christalized acids heaping up in the knee after errors in the body’s metabolism. After reading about the gout causes, I understand why the doctor is studying the ‘pseudo-gout’ option. This ailment looks similar to gout, but this time the chrystals are formed by calcium and not acids. And the circumstances are different.
Some 90ml of excessive (yellow) fluids were extracted from my knee last week and are now being examined, along with new bloodtests and X-rays. A new medication makes me feel lots better and should reduce the inflammation cause. In total, it feels like getting more serious attention, but with a less clear outlook.
A cure for pseudo-gout isn’t around the corner unfortunately. But it can disappear as sudden as it started. Your body has to recover by itself and wash out the calcium chrystals. In two weeks I will know what my physical future holds in terms of sports and exercise. Maybe the current medicins will do the trick and will allow me to start training again.