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Chondromalacia

Q: I am 44 years old and suffer from pain in my right knee while playing tennis and badminton. This pain disappears if I give a break of 3-4 days. Kindly suggest what should i do about this problem?

A:From your description of symptoms you seem to be having chondromalacia patellae - (Chondro is cartilage, malacia is ailment and patellae means knee cap). In this the cartilage lining of the under surface of the kneecap starts flaking due to degeneration. This degeneration could be as a result of normal ageing or as a result of some injury to the knee. Climbing down a flight of stairs causes the kneecap to be tightly pressed against the knee part of thighbone. This causes pain. Vigorous athletic activities also worsen the symptoms. You report that X-rays are normal. In routine X-rays for chondromalacia patellae this is the usual finding. You need to get special views called skyline views of the patellae. Yours symptoms could also be as well as of very early generalised degenerating of the knee including the kneecap. Occasionally such symptoms are as a result of deposition of uric acid crystals in the joint. You will need to get serum uric acid levels done. This is a blood test, which can be done easily in most biochemistry labs. Treatment of this condition is to avoid rigorous athletic activities and climbing of stairs till acute pain lasts. If pain is severe you could take a pain killer in consultation with your family doctor. This is only for symptomatic relief. In painful conditions of the knee, front of thigh muscles waste rapidly. This makes the knee more vulnerable to further damage so the most important part of treatment is to ensure that the front of thigh muscles (quadriceps) remain in good tone and strength. You will have to learn this from a physiotherapist or from an orthopaedic surgeon.

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