Knee Pain and Swelling: Insights for Expecting Mothers

Q: Knee Pain and Swelling: Insights for Expecting Mothers

In response to your question： Based on your description, it is somewhat unusual that you are taking Keflex (500mg), which is an antibiotic typically used for bacterial infections and is rarely prescribed for knee pain. <br>Given your situation, I recommend that upon returning to

Knee swelling and pain?

Hello Dr.
Zheng, my knee has been swollen and painful for over a year.
I later consulted an orthopedic doctor who drained about 30cc of hematoma.
After that, my knee could not move normally.
After three months of rehabilitation and traditional Chinese medicine massage, it was almost back to normal.
However, I stopped the rehabilitation and massage in February due to my pregnancy, but there were no unusual symptoms.
In September of this year (28 weeks pregnant), I flew to the United States to prepare for childbirth.
On the fourth day in the U.S., I started experiencing swelling and pain again.
It wasn't as swollen as before, but it was very painful.
This lasted for four days, and by the fourth day, the swelling had subsided, but there was still pain.
I then consulted an obstetrician, who prescribed me Keflex (500mg).
After taking it for two days, the pain disappeared, and I returned to normal.

After giving birth, I couldn't rest properly due to taking care of the baby.
My mother-in-law helps, but I insist on taking care of the baby myself, sleeping only about four hours a day, but there have been no unusual symptoms until now.
A week ago, I changed the way I bathe the baby, and I often squat.
Four days ago, my knee started hurting again.
The day after the pain started, I took Keflex (500mg) again, and the next day my knee swelled up again.
It doesn't hurt now, but there is some swelling (located on the outer side below the left knee, near the joint with the tibia).

I would like to ask the doctor:
1.
Over a year ago, the doctor mentioned that I might need an arthroscopy, but I did not follow the doctor's advice.
Do I need to have an arthroscopy now?
2.
What are the possible conditions (arthritis, soft tissue issues, ligament problems, meniscus issues, or others)?
3.
I will return to Taiwan in February; can I have a detailed examination then?
4.
Will the swelling resolve on its own?
5.
What behaviors should I be cautious about?

Miss Lin, 20~29 year old female. Ask Date: 2005/12/27

Dr. Zheng Shunping reply Rehabilitation

In response to your question: Based on your description, it is somewhat unusual that you are taking Keflex (500mg), which is an antibiotic typically used for bacterial infections and is rarely prescribed for knee pain.
Given your situation, I recommend that upon returning to Taiwan, you visit a rehabilitation specialist for a joint ultrasound examination, which should help diagnose the underlying cause.
Currently, there is no urgent need for invasive arthroscopic examination.
In the meantime, please rest well.
If it is not a bacterial infection, you can apply local heat, avoid prolonged squatting and climbing stairs, and your symptoms should improve.
A thorough examination can be conducted once you return to Taiwan.

Reply Date: 2005/12/27

More Info

Hello! Thank you for your detailed question regarding your knee pain and swelling, especially during your pregnancy. It’s important to address these concerns comprehensively, as they can significantly affect your quality of life and mobility.

1. Need for Arthroscopy: Given your history of knee swelling and pain, particularly after having fluid drained from your knee over a year ago, an arthroscopy may still be a valuable diagnostic tool. This minimally invasive procedure allows doctors to visualize the inside of the knee joint and assess for issues such as meniscal tears, cartilage damage, or other intra-articular problems. If your symptoms persist or worsen, it would be prudent to consider this option, especially if conservative treatments do not yield satisfactory results.

2. Possible Conditions: Your symptoms could be indicative of several potential conditions:
- Osteoarthritis: This is common in individuals with a history of knee issues and can lead to joint pain and swelling.

- Meniscal Tear: Given your previous knee issues, a tear in the meniscus could cause pain, especially with certain movements.

- Ligament Injuries: Injuries to the ligaments (like ACL or MCL) can also lead to pain and instability.

- Bursitis: Inflammation of the bursae around the knee can cause localized swelling and pain.

- Tendonitis: Overuse, especially with the physical demands of caring for a newborn, can lead to tendonitis in the knee area.

- Gout or Pseudogout: These conditions can cause sudden swelling and pain in the knee due to crystal deposits.

3. Follow-Up in Taiwan: Yes, when you return to Taiwan, it would be wise to seek a thorough evaluation from an orthopedic specialist. They can perform imaging studies, such as X-rays or MRIs, to better understand the underlying cause of your symptoms and recommend appropriate treatment.

4. Self-Resolution of Swelling: Swelling can sometimes resolve on its own, especially if it is due to minor inflammation or overuse. However, if the swelling persists or is accompanied by significant pain, it is essential to seek medical advice. Rest, ice, compression, and elevation (RICE) can help manage swelling in the meantime.

5. Behavioral Considerations: Here are some recommendations to help manage your knee health:
- Rest: Ensure you allow your knee adequate rest, especially after activities that exacerbate your pain.

- Ice Therapy: Applying ice to the affected area can help reduce swelling and alleviate pain.

- Avoid Prolonged Squatting: Since you mentioned using a squatting position while bathing your child, try to minimize this position if it causes discomfort.

- Strengthening Exercises: Engage in gentle strengthening exercises for the muscles around the knee, but avoid any movements that cause pain.

- Weight Management: Maintaining a healthy weight can reduce stress on your knees, especially during pregnancy.

- Proper Footwear: Wear supportive shoes to help with alignment and reduce strain on your knees.

In conclusion, while it’s encouraging that your symptoms improved with medication, ongoing knee pain and swelling warrant further investigation. It’s essential to listen to your body and seek medical attention if your symptoms persist or worsen. Take care of yourself, especially during this demanding time of motherhood, and prioritize your health to ensure you can care for your child effectively.

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