Young Adult Experiencing Persistent Knee Popping and Pain
A 20-year-old male, who is 6'1" tall and weighs 168 pounds, identifies as white and is a non-smoker with occasional alcohol consumption. He does not take any prescription medications and does not use recreational drugs. Today, during a warm-up session that included jump roping and jumping jacks, he noticed his right knee emitting popping sounds with every step he took. Although he is experiencing discomfort in his knee, which has been a recurring issue for the past two months, he is unsure if the sounds are the source of his pain or if they are simply coincidental. The onset of his knee discomfort traces back to over two months ago when he was lifting a pallet at work and felt a sudden sharp pain in his leg. This incident was accompanied by a brief episode of blurred vision. Initially, the pain was quite intense, but it gradually improved with the use of a compression brace; however, this brace has not alleviated the popping sensation. The popping noise has persisted since it began around 4 PM and continues as of 10 PM. He is considering seeking urgent care if the symptoms do not improve by the next morning.
Answers (1)
12/14/2025, 3:20:33 AM
OpenHealth AI
It's understandable to be concerned about persistent knee popping and discomfort, especially after experiencing a sharp pain following physical activity. The popping sound in your knee, often referred to as "crepitus," can be caused by various factors, such as air bubbles in the joint fluids or changes in the knee's cartilage. However, since you're also experiencing discomfort and have a history of an injury, it’s essential to take the right steps to manage your symptoms.
Explanation
The popping in your knee may not always indicate a serious issue, especially if it's accompanied by no swelling or locking of the joint. However, given your history of acute pain after lifting a heavy object, it’s wise to be cautious. Sometimes, knee issues can stem from minor soft tissue injuries or even early signs of tendonitis, especially if the discomfort is not resolving. The blurred vision you experienced briefly could be unrelated but is something to consider as you monitor your symptoms.
Next Steps
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Rest: Avoid activities that could stress your knee, particularly jumping or lifting heavy objects for now, to allow time for healing.
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Ice the Knee: Apply ice packs to your knee for 15-20 minutes several times a day to help reduce any swelling and pain you might be experiencing.
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Elevate and Compress: Keep your knee elevated when sitting or lying down, and continue using a compression brace, if it's comfortable. Make sure it's not too tight, which could hinder circulation.
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Modify Activities: Consider incorporating low-impact exercises, such as swimming or cycling, to maintain fitness without stressing the knee.
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Monitor Symptoms: Keep track of any changes in pain, swelling, or new symptoms like instability. If you notice significant worsening or if your knee feels unstable, seek urgent care sooner rather than later.
If your symptoms do not improve over the next few days, or if you have concerns about the intensity of the pain, a healthcare provider can perform a detailed assessment to rule out any underlying injuries. Remember that taking these proactive steps can often help in managing your symptoms more effectively. Let me know if you have further questions or need more advice!
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.