OpenHealth Q&A

Seeking Guidance on Knee Inflammation and Associated Symptoms

Background: Female, 36 years old, 5 feet 6 inches tall, weighing 155 pounds, residing in the United States. I maintain a clean lifestyle - I do not consume alcohol, smoke, or use recreational drugs. Current Medications/Supplements: Taking buspirone 5mg every day and Vitamin D daily. For the last several years, I have struggled with knee inflammation that sometimes accompanies pain in other parts of my body, most notably in the neck, shoulders, and back, potentially related to lymph nodes. My pursuit of a proper diagnosis has left me uncertain about the next steps. I have consulted with my primary care physician and am seeing a rheumatologist. Any recommendations for additional specialists would be greatly appreciated, as I suspect all my symptoms might be interconnected - the knee inflammation, possible lymph node discomfort, and a correlation with my menstrual cycle. Below is a detailed account of my current flare-up, along with a more extensive medical history subsequent to that. **Summary of Current Events – Flare-Up Timeline** **February 5, 2026** – My knee experiences a significant flare-up, becoming inflamed and painful in the evening. This is particularly noteworthy since my menstrual cycle ended on February 4; previously, flare-up episodes typically occurred during or before my period. **February 6, 2026** – I attend an appointment with my rheumatologist where they successfully extract fluid from my knee. The fluid appears yellowish yet clear. Additional blood tests were conducted. I received a steroid injection in my knee to alleviate the discomfort, which the doctor indicated would take a few days to show full effect. **February 7, 2026** – Although there’s a slight improvement in my knee pain, my body starts to feel sore all over, especially in areas correlating with lymph node locations, limiting my movement and comfort when wearing certain clothing. **February 10, 2026** – I reach out to my rheumatologist via the patient portal regarding the new pains, mentioning their recurrence during knee flare-ups. The response indicates that these symptoms are likely linked to my underlying inflammatory issue, and a steroid pack is offered if the pain persists. Fortunately, the pain that began on February 7 has gradually improved over the next few days, so I choose to forgo the steroid treatment. That evening, I receive results indicating that the knee fluid analysis showed mild inflammation, suggesting an ongoing inflammatory process. **February 11, 2026** – I wake up with only a slight ache in my knee and lymph nodes, feeling optimistic about recovery. However, later in the morning, I notice bright red blood during a restroom visit, with a thin consistency that alarms me, especially since my last period ended on February 4 and my cycles are typically regular. This unanticipated bleeding and cramping feels distinct from my usual menstrual symptoms. I ponder whether it may relate to my recurring knee issues given their historical correlation with my menstrual cycle. I send another message inquiring about diagnostic steps and future actions, noting that my rheumatologist currently categorizes my condition as seronegative inflammatory arthritis, suggesting inflammatory arthritis without identifiable blood markers. **Additional Context/Comprehensive Medical History** **2023 – Previous Episodes** Visited a water park from September 7 to 10, which involved extensive walking and climbing stairs. Developed knee pain and swelling by September 12, leading to a visit to my primary care doctor on September 14. Treatment with prednisone began on the evening of September 14; while the knee pain subsided, a pervasive soreness throughout my upper body emerged, particularly sensitive when touched. This body pain felt worse than the knee discomfort I had experienced and echoed symptoms I had encountered about 9 to 10 months prior, seemingly linked to lymph node areas. After reaching out to my doctor through the patient portal on September 17, I had blood drawn for further tests on September 20. I ceased taking prednisone and switched to naproxen for pain relief around that time; while it provided some alleviation, it didn’t completely eliminate the pain. By September 24, the body pain had decreased, but knee discomfort intensified. Blood work returned negative for all tests conducted on September 25. On September 27, after a few days of persistent knee discomfort, I opted to try an arthritis topical gel instead of naproxen. I utilized it twice daily from September 27 to October 11, finding slight improvement in pain levels, with aggravation particularly regarding stair use, kneeling, or standing for prolonged periods. Historically, I experienced bursitis in my right knee around 2017 or 2018, with pain and swelling that was considerably more intense than my current experience. That condition resolved after a strong steroid dose, but knee issues have recurred towards the end of steroid treatment. **October 2023** Began experiencing erratic bleeding and spotting that began around November 15, after my previous period ended on November 7. Spotting continued until December 5, correlating with my following cycle. In a December 4 ultrasound, no issues were identified, leading my gynecologist to dissipate concerns regarding the abnormal spotting. However, I have noted painful intercourse and other symptoms persisting since November, ultimately prompting an assessment with my gynecologist in summer 2024. Furthermore, ongoing pain necessitated further consultation and treatment options. **March 2025** First appointment with the rheumatologist to address the chronic knee inflammation and pain, experiencing episodes of instability. Noteworthy historical incidents include an acute bout of bursitis leading to significant mobility restrictions, which eventually responded to medical intervention. Throughout the years, variations in stress and menstrual cycles appear to influence the frequency and severity of my symptoms, often requiring additional aids such as a cane for mobility. **Family Health Background** My mother's health history is uncertain, though my grandmother and great-grandmother both faced severe knee-related complications, with my grandmother undergoing multiple surgeries leading to full knee replacement. Genetic predispositions may thus play a role in my current experiences. This commentary reflects my ongoing efforts to navigate these health challenges, seek proper diagnosis, and develop a comprehensive treatment plan that addresses the complexities of my symptoms.

Answers (1)

2/11/2026, 8:21:21 PM

OpenHealth AI

It sounds like you're going through quite a challenging time with your knee inflammation and associated symptoms. It’s understandable to feel concerned, especially with the potential connections to your menstrual cycle and lymph nodes. Let’s break down your situation and prioritize actionable steps.

Main Points:

• You're experiencing knee inflammation and pain that may correlate with your menstrual cycle, along with discomfort in other body areas.
• A potential diagnosis of seronegative inflammatory arthritis has been suggested, indicating an inflammatory condition without specific blood markers.
• Ongoing symptom monitoring and proper communication with your healthcare providers is crucial.

Explanation:

Your symptoms, including knee inflammation and body soreness during your menstrual cycle, suggest a systemic inflammatory condition. The fluid analysis indicating mild inflammation supports this possibility. The bright red bleeding you've experienced, especially when it differs from your usual menstrual pattern, should also be taken seriously, as it may indicate a related issue worth further investigation.

Given that you have consulted both a primary care physician and a rheumatologist, you are on the right track for specialized care. Additionally, because your symptoms might interact with hormonal changes and your gynecological health, involving a gynecologist in your discussions could provide valuable insights.

Next Steps:

1. Continue Monitoring Symptoms: Keep a detailed diary of your symptoms, including pain levels, timing in relation to your menstrual cycle, and any other notable changes (e.g., dietary habits, stress levels). This can help identify patterns and inform discussions with your doctor.

2. Follow-Up with Specialists: Ensure regular follow-ups with your rheumatologist regarding the knee inflammation and the new symptoms. Given the potential correlation with your menstrual cycle, it may be beneficial to return to your gynecologist as well, especially to discuss the sudden bleeding and ongoing pelvic pain.

3. Consider Additional Specialist Consultations:

   • Endocrinologist: Since you suspect a connection between your symptoms and hormonal fluctuations, an endocrinologist can evaluate your hormonal health and any potential dysfunctions.
   • Pain Management Specialist: If your pain persists, a pain management expert can provide tailored interventions to improve your quality of life.

4. Self-Care Measures:

   • Rest and Elevation: Allow your knee adequate time to rest and elevate it when sitting to manage inflammation.
   • Ice Therapy: Applying ice can help reduce inflammation and provide comfort during flare-ups.
   • Gentle Movement: When possible, engage in gentle, low-impact exercises like swimming or cycling to maintain mobility without overstraining your knees.

5. Communicate Changes Promptly: If you experience worsening symptoms, such as increased bleeding, severe pain, or new symptoms, inform your healthcare team immediately.

If you have any other questions or need further clarification on any specific aspect, please don’t hesitate to ask. You are taking the right steps towards understanding and managing your health, and it’s important to maintain that proactive approach.