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Acute knee pain along side possible flare
I have my Rheumatologist stumped. I've had acute knee pain since Aug. 20 and cannot bear weight which makes it difficult to walk without holding on to things. I'm missing work.
I've had an x-ray via Urgent Care which shows meniscal calcium crystals. Rheumo doesn't believe this is enough to cause the degree of pain I'm experiencing. I thought maybe he could drain my knee to relieve pressure and analyze the crystals. He determined that there wasn't enough swelling/fluid to get a specimen. I showed him a very tender spot on my knee and he's taking a gander that it's Pes Anserine Bursitis and administered a Cortisone injection. He also ordered an MRI in case that's not the answer. It'll be a week out to get that authorized.
It's really hard for him and me to figure where I'm at with the taper. I'm staying at 7 mg. until we can sort this knee thing out. He said that he is tempted to bang up the Prednisone but knows I don't do well with that. And the PMR symptoms (with the exception of my left hip at night) seem mild at this time compared to the knee. I may have withdrawal symptoms still going on. No wonder because my CRP is up again and my Cortisol is 3.5.
Anybody got a similar story?
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I'm on a prednisone taper and the pain in my right knee that I had gotten used to over years before prednisone returned once I breached the 10mg point. Did you have any issues before starting prednisone? I don't know if it's possible to damage a joint while on prednisone because the prednisone masks the pain, but I know all my achy joints felt better on prednisone.
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2 ReactionsI have GCA and PMR since January 2024 . PMR in January 2024 and GCA started Slightly November 2024 but really got worse in August 3025. I went to emergency thinking I was having a GCA attack and they ended up finding 2 aneurysms. I had a stent put in and went on 60 mg prednisone. Because of restricted blood flow to my eyes. Anyway I have finally tapered to 7 mg today after going back and forth since last year because anytime I hit below 25 mg I would get the headaches again. I started actemera in May which has helped me taper to 7. But now I have pain in both my knees to the point it’s hard to get up and down from the couch. I have an appointment tomorrow plus my infusion and I will be talking to my doctor to see what is going on with my knees.
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1 ReactionCalcium crystals. Did anyone say the crystals indicate cppd?
Calcium pyrophosphate deposition.
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1 Reaction@kjoed53
I had pain in the opposite knee several years ago which responded well to one Cortisone injection. But generally no. Maybe mild osteoarthritis. And an MRI shows that I do have age-related LS spine degeneration. I'll keep everyone posted after I have the MRI of my knee.
At least I'm walking a little better, but I'm not ready to take a walk or go back to work standing on my feet for hours.
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1 Reaction@pmrsuzie
No. Rheumo keeps downplaying the crystals as a reason for my pain.
I have a terrible time with my right knee, and I have had that one replaced! I have a bad right hip, which doesn’t hurt nearly as bad as that knee! However, the hip has caused changes in the way I walk, causing the knee to be out of line and hurt so badly sometimes I can’t sleep unless I put an ice pack on it. I found a series of very mild exercises for tight hips on YouTube. I empathize they are very light meant to build up the muscles around my hip to align it better. This has helped my knee very much. Also if your foot turns in on the affected side even slightly get an insole insert that levels out your foot.
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2 ReactionsI was weaned down to 7.5 mg of prednisone for my PMR and my right knee started hurting me. I had no PMR pain in my legs and arms. The pain in my knee was so bad I went to 9 mgs of Pred. I had an x-ray done and saw an orthopedic doctor and he said I had moderate osteoarthritis on my knee and suggested physical therapy. I started therapy and everything was going well but then my right upper arm started hurting me. I couldn't sleep because of my arm pain, so I increased the prednisone to 11 mgs. I figured I had another flare up of the PMR. I really want to decrease my prednisone dosage but in the last year I'd had 2 flare ups now. My last 3 Sed Rate (ESR) blood tests have been normal. I've been on a low glucose diet for the last 4 months. This is getting really frustrating.
@pah17
This is my experience with calcium crystals:
I had a knee x-ray that indicated cppd arthropathy along with OA, was treated with a cortisone injection.
My hand xrays twice indicated the same, cppd arthropathy along with OA. They were swollen, warm to the touch, painful. My crp was elevated. My rheumatologist suggested methotrexate or hydroxychloroquine. Upping the prednisone dose a little is what worked.
I think not all calcium crystals are cppd.
@pmrsuzie A doctor identified the calcium pyrophosphate dihydrate crystals in my knees about 20 years ago when my knee was x-rayed for some kind of problem. They have never been a problem for me. I walk or jog 4 miles every day. Google says about 50 percent of people over 85 have the crystals, and many people have no pain, swelling, or inflammation from the crystals.
@jeff97
I do not think the crystals in my knee are a problem either. The ones in my hands have been a couple times. At the time, my rheumatologist was 'concerned'. He's always looking at my hands every visit.