I have been experiencing severe knee and associated toe pain for about 5 years now. During my freshman year of college, I went to squat down to get something and I found I could not get up. My knees got incredibly stiff and a sharp pain ran up and down my legs, originating in what felt like within my knee cap or slightly above. I was then diagnosed with patellofemoral syndrome (though I am a light exerciser and I do not run). They have since only gotten worse, and I continued to see a rheumatologist. My blood work and X-rays showed no signs of arthritis, though he thought it could be unmarked, so he tried me on Plaquenil. I had horrendous side effects, and although I thought the medication could be helping, I stopped it because I could not get out of bed (exhaustion) being the biggest side effect. They are worst when bent at a 90-degree angle of less, when squatting, or standing in place. They are warmer to the touch and there is a balled-up muscle on the upper, outer corner of each knee (though my right is worse). When my extremities get too cold (toes), the pain in my knees seem to worsen, Currently, I am having a major flare-up, and they seem to grind when bent, and if I squat to pick something up, I get pins and needles. They are extremely painful in the mornings, but the pain is constant. I have experienced maybe a tad of numbness. I can feel a new pain coming from behind and on the outside of my knees now, that continues up my hamstrings and into my lower back, causing more stiffness. I also have a very tight IT band that I have been trying to massage out. I am desperate for help and am only 23 years old. It makes it extremely difficult to work out or have the motivation to because I know I will be in pain for days, and just do not know what to do anymore. I have not had any major falls, though I was a dancer for some time in my childhood and tended to lock my knees a lot growing up. I have since tried to keep them unlocked, but everything seems to cause pain no matter how I compensate. Could it be bursitis? Arthritis? Reynaud's?

Comments (1)
No. 1-1

Yours is a complicated story but sounds very much like chondromalacia patellae. Women are at risk of this problem because of a wider pelvis that will increase the angle of the thigh bone on the tibia causing potential rubbing of the knee cap cartilage on the femur..The grinding with bending suggests the cartilage is no longer smooth and is a source of irritation. These changes would not be seen on an Xray A MRI may show the changes of the cartilage more clearly. A number of therapies are possible for this problem Physical therapy to try to strengthen the appropriate portion of the quad muscle is important. A physical therapist can also tape a knee cap that it tracks on a better path. The use of aspirin-like medicines can make doing the exercises easier. If those interventions do not work, hyaluronic acid injections may be helpful in improving the function of the cartilage. This problem can be an early phase of osteoarthritis, For more information about osteoarthritis, go to and

David G. Borenstein, M.D. MACP., MACR.
CONFIDENTIAL: The information contained in this electronic message and any attached documents may contain confidential and privileged information that is for the sole use of the intended recipient(s). If you are not the intended recipient, note that any unauthorized review, disclosure, copying, distribution, or use of the contents of this electronic message or any attached documents is prohibited. If you have received this communication in error, please destroy it and notify Arthritis & Rheumatism Associates, P.C., immediately

Mechanical Disorders