My mid-twenties daughter has developed increasing sharp ache in the both the left hip and knee today. No recent injuries and no unusual activity. This has come on over the last three to four hours and is becoming unbearable. Although she has a high pain tolerance,she has warned me that she may ask to be taken to the hospital if it gets any worse. Do these symptoms describe anything that anyone recognizes?
Rapid onset joint pain, which is of this severity, is very concerning. The examining physician will want to know a bit about the patients history, including: allergies, medicines used, current and past illnesses, travel history, occupation, pets or animal contacts, vaccination history, sexual activity history, use of illicit substances, and possibly more.
Though septic arthritis (infected joint) is much more common in infants and children, it does occur in adults also. This is always near the top of the list in excruciatingly pain, rapid onset joint pain. It usually only affects one joint, but, it can be in multiple joints. Septic arthritis in adults is usually more common in IV drug abusers, sexually active individuals, and immunocompromised patients, but just ordinary people can get it also.
Septic arthritis is always ruled out early, because missing it or a significant delay in treating it can lead to destruction of the joint, systemic problems, and possibly even death. It is a significant condition in adults.
It could be an acute onset of one of the hundreds of inflammatory arthropathies. Often it initial presentation can be dramatic, then once under control, they usually quite down, with only periodic flares. These more commonly affect multiple joints.
There are many of these conditions, but Gout, Lyme Disease, Reiter's syndrome, inflammatory arthritis brought on by an allergic reaction, psoriatic arthritis, rheumatoid arthritis, SLE (Lupus) are just some of them.
An acute prolapse of a disc in the spine can cause referred pain to the dermatome of the nerve root(s) involved. Thus it could cause pain in the lower extremity, including the joints.
Sickle cell disease is another cause of acute onset joint pain. This is more common in certain ethnic groups.
There are certain tumors that can cause significant joint pain. PVN (pigmented villonodulus synovitis) is a common one, but usually it affects the knee, hip is less common.
As you can see, rapid or acute onset joint pain of an excurciating nature is very concerning for some serious conditions. In the absence of trauma, these condition have to be considered and ruled out.
A thorough examination of the whole body, looking for skin rashes or lesions, is important. Examination for infections in the throat or genitalia also should be done. Of course blood work must be done: CBC with differential, Chem 20, UA, ESR, CRP, RF, ANA, HIV, Hepatitis, Strep, Lyme titer, Uric acid level, and/or anything else that the examination directs.
If the pain your daughter has not decreased, or is increasing, she should be seen immediately. If she has a documented fever with a thermometer, that increases the need to be seen.
Hope your daughter is feeling better soon. Good luck.
We applied a heat pack to her lower back and gave Ibuprofen. She had been riding in a car all afternoon and I treated for lower back pain after reading at this site. She does have Lymes disease and digestive issues (the latter of which have been maddeningly stubborn in diagnosing). Since she has seen flare ups before, I have asked her to see her doctor about the episode. Thankfully we have recent blood work and other lab tests. She is being monitored fairly closely due to her previous conditions. The pain subsided overnight to soreness and today is gone. I will forward this to her, and am thankful for your long and thoughtful reply.
In some cases of Lyme disease, even if it has been adequately treated, for the patient to be an antibiotic nonresponder. In these cases, the patient can have periodic flares of the Lyme arthritis. These episodes can mimic septic arthritis in terms of pain and white blood cell count inside of the knee.
In fact, back in the 70's and 80's before Lyme disease was well known, many cases of Lyme were mistaken for septic arthritis. Many patients underwent surgical debridements of the joints.
So, Lyme flares can be very painful and appear almost identical to that of a septic joint. She should always inform the physicians who do not know her, that she has a history of Lyme disease.
Of course, this does not mean that she cannot get the other conditions. As one doctor once told me, a patient can have two disease processes going on, just like a dog can have both ticks and fleas. Just because a patient is known to have a particular disorder, do not get lulled into missing something else.
Need advice!! Im 28yr old female i have had problems with my hips since i was thirteen and now getting worse and my knee is now really hurting with sharp pains when i straighten my leg and then it aches when resting.
my hips are always sore i cant exercise and when bad i cant even walk. My hips crunch and sharp pains when iv been walking a while. Please any advice will help.